Skenario C Blok 24 FK UNSRI 2016

A male baby was born at type C Public Hospital from a 41 years old woman. Her mother,
Mrs. Anita was hospitalized at the Hospital due to uterine contraction. It was her third pregnancy.
She forgot when her first day of last period, but she thought that her pregnancy was about 7
months. Her other children were born preterm too, about 8 months. Now, they are 4 years old
and 2 years old.
Four hours after admitted, she delivered her baby spontaneously. The labor process was
30 minutes, and ruptured if membrane was one hour before delivery. The liquor was clear. The
baby was not cried spontaneously after birth, but grunting and his whole body was cyanosis.
Pediatrics resident who resuscitate the baby did first step of resuscitation to the baby. APGAR
score at first minute was 3 and fifth minute was 7.
On physical examination
Body weight was 1350 grams, body length was 41 cms, and head circumference was 31
cm. The musle tone was decreased, he was poorly flexed at the limbs, he has thin skin, more
lanugo over the body and plantar creases 1/3 anterior. At 10 minutes, he still had grunting and
cyanosis of the whole body, respiratory rate was 86 breaths per minute, there were epigastric
retraction, breathing sound decreased. Heart rate 156 beats per minute. Saturation 85 % with
nasal oxygen
I.

Klarifikasi Istilah
a. Sianosis : Perubahan warna kulit dan membrane mukosa menjadi kebiruan akibat
konsentrasi hb tereduksi yg berlebihan dalam darah
b. Prematur Preterm Ruptur of membrane : Pecahnya ketuban sebelum ada tandac.
d.
e.
f.

tanda persalinan pada usia kehamilan < 37 mgg

Preterm: Kelahiran bayi antara 20 mgg 37 mgg
Lanugo : rambut halus pada tubuh janin
Resusitasi : Menghidupkan kembali seseorang yang tampaknya meninggal
Apgar score: Metode praktis yang digunakan untuk menilai keadaan bayi sesaat
setalah melahirkan, fungsinya untuk melihat untuk mengetahui apkah bayi
menderita aspiksia

II.

Identifikasi Masalah

a. A male baby was born at type C Public Hospitsal form a 41 years old woman. Her
mothers. Anita was hospitalized at the hospital due to uterine contraction.
b. It was her tthird pregnancy. She forgot when her first day of last period, but she
thought that her pregnancy was about 7 months. Her other children were born
preterm too, about 8 months. Now they are 4 years old and 2 years old.
c. Four hours after admitted, she delivered her baby spontaneously. The labor
process was 30 minutes, and ruptured of membrane was one hour before delivery.
The liquor was clear.
d. The baby was not cried spontneusly after birth, but grunting and his whole body
was cyanosis.
e. Pediatric resident who resuscitate the baby did first step of resuscitate to the baby.
APGAR score at first minute was 3 and fifth minute was 7.
f. On physical examination
Body weight was 1350 grams, body length was 41 cms, and head circumference
was 31 cm. The musle tone was decreased, he was poorly flexed at the limbs, he
has thin skin, more lanugo over the body and plantar creases 1/3 anterior. At 10
minutes, he still had grunting and cyanosis of the whole body, respiratory rate was
86 breaths per minute, there were epigastric retraction, breathing sound decreased.
Heart rate 156 beats per minute. Saturation 85 % with nasal oxygen

III.

Analisis Masalah
1. A male baby was born at type C Public Hospitsal form a 41 years old woman. Her
mothers. Anita was hospitalized at the hospital due to uterine contraction.
a. Apa hubungan umur ibu dan jenis kelamin bayi pada kasus? Charita Aulia
sandy
b. Bagaimana fasilitas rumah sakit tipe C? Aulia charita Sandy

c. Bagaimana tanda-tanda inpartu?Bayu ekik

2. It was her third pregnancy. She forgot when her first day of last period, but she
thought that her pregnancy was about 7 months. Her other children were born
preterm too, about 8 months. Now they are 4 years old and 2 years old.

a. Bagaimana cara menentukan usia kehamilan dan hari perkiraan lahir? Azis,
Alif
b. Bagaimana hubungan riwayat diatas dengan kelahiran preterm pada kasus?
Marlan, dul
c. Apa dampak bayi lahir preterm? Marlan dul
d. Apa etiologi dari kelahiran preterm? Fania dinda

3. Four hours after admitted, she delivered her baby spontaneously. The labor
process was 30 minutes, and ruptured of membrane was one hour before delivery.
The liquor was clear.
a. Bagaimana proses persalinan normal? Fania, dinda
b. Apa dampak dari proses persalinan presipitatus? Azis Alif
c. Apa dampak ketuban pecah dini preterm? Bayu Ekik
d. Apa makna klinis cairan ketuban jernih? Rani Ameng
4. The baby was not cried spontneusly after birth, but grunting and his whole body
was cyanosis.
a. Apa etiologi dan mekanisme bayi tidak menangis tetapi merintih dan
cyanosis? Rani, Ameng
5. Pediatric resident who resuscitate the baby did first step of resuscitate to the baby.
APGAR score at first minute was 3 and fifth minute was 7.
a. Bagaimana algoritma resusitasi pada neonates? Dul, Marlan
b. Bagaimana cara menilai apgar score dan apa interpretasi pada kasus? Rani
Ameng
6. On physical examination
Body weight was 1350 grams, body length was 41 cms, and head circumference
was 31 cm. The musle tone was decreased, he was poorly flexed at the limbs, he
has thin skin, more lanugo over the body and plantar creases 1/3 anterior. At 10
minutes, he still had grunting and cyanosis of the whole body, respiratory rate was
86 breaths per minute, there were epigastric retraction, breathing sound decreased.
Heart rate 156 beats per minute. Saturation 85 % with nasal oxygen
a. Bagaimana interpretasi dan mekanisme abnormal dari pemeriksaam fisik?
Aulia Charita sandy
b. Bagaimana pemeriksaan Ballard score? Fania dinda

c. Apa saja klasifikasi BBL? Bayu, ekik

d. Bagaimana hubungan berat bayi dengan sesak nafas? Azis Alif
Analisis Aspek klinis (RDS)
a. Bagaimana cara penegakkan diagnosis pada kasus? Dinda Fania
b. Apa saja DD? Aulia Charita sandy
c. Apa WD dan definisi? Azis, alif
d. Bagaimana epidemiologi pada kasus? Dul, Marlan
e. Bagaimana etiologi pada kasus? Rani, Ameng
f. Apa faktor risiko pada kasus? Bayu ekik
g. Bagaimana patofisiologi pada kasus? Azis alif
h. Bagamana manifestasi klinis pada kasus? Rani Ameng
i. Bagaimana tatalaksana dan KIE pada kasus? Dul, Marlan
j. Apa komplikasi pada kasus? Bayu ekik
k. Apa prognosis pada kasus? Dinda, Fania
l. Apa SKDI pada kasus? Aulia Charita sandy
IV.

Hipotesis
Bayi laki-laki dari Ibu Anita 41 tahun mengalami sindroma distress respiratory e.c
ketuban pecah dini preterm

V.

Learning Issue
a. PPROM Fania, Dinda, Marlan, Charita, dul, Aulia
b. RD Rizki, bayu, Azis, Rani, Ameng Sandi, Alif