VI. EMERGENCY ROOM REPORTMonday, November 2nd, 2015 until Wednesday, November 4st, 2015

OBSTETRICS Physiological patient : 3 cases Pathological patient : 4 cases

GYNAECOLOGY : - case Total : 7 cases

Emergency room chiefsDr. Astri Sri Widyastuti : 1 caseDr. Afan Novantri : - case

Total : 1 case

OBSTETRIC CGH, RZMNo Initial Age Diagnosis Treatment Physician

1. Mrs. YUL 23

G2P1A0 38 weeks gestational age not inlabor with PROM 13 hours single

life fetus cephalic presentationPlan for vaginal

delivery CGH

2. Mrs. SUC 24

G5P2A2 30 weeks gestational age with threatened preterm labor + APS was suspected SLF cephalic presentation

Conservative management RZM

3. Mrs.SIS 27

G3P2A0 36 weeks gestational age not inlabor with PROM 12 hours + prior LSCS 1x SLF cephalic presentation

Conservative management RZM

4. Mrs.BAL 34

G4P3A0 39 weeks gestational age inlabor 2nd stage with severe

preeclampsia SLF vertex presentationForcipal extraction CGH

GYNAECOLOGY/ONCOLOGY CGH,RZM

No Initial Age Diagnosis Treatment Physician- - - - - -

OBSTETRICDr. Astri Sri Widiastuty

3.11.15 Forcipal extraction due to severe preeclampsiaMrs. BAL/34/UA/CGH/BAR

11:56 AM D/ G4P3A0 39 weeks gestational age inlabor 2nd stage with severe preeclampsia SLF vertex presentation

BP : 220/120mmHg

Protein : ++GI : 8

M/ Stabilization 1 hourObs. Vital sign and FHRIVFD RL xx gtt/m

HIII Inj. MgSO4 ∞ protocol Nifedipin 10mg/8 hour Laboratory examination Plan for vaginal delivery (Terminate 2nd stage with action) Tubal ligation counseling

01:15 PMBP : 160/100

mmHgGI : 6

D/ G4P3A0 39weeks gestational age inlabor 2nd stage with severe preeclampsia single life fetus vertex presentation

M/ Forcipal extraction Episiotomy mediolateral

01:30 PM Female life baby was born, BW 3800 g, BL 50 cm, A/S 8/9 FTAGA

01:40 PM Placenta was delivered completely, PW 520 g, umbilical cord length 50 cm, Ø19x20 cm

Mother and baby was in good conditionFOLLOW UP

Nov 5th, 201507: 00 AM

Hb 9,1Leu 22.600Plt 434.000LDH : 804

D/ P4A0 post forcipal extraction due to severe preeclampsia with partial HELLP syndrome day II

M/ - Observation vital sign- Inj. Dexamethasone 10mg/12 hours IV- Methyl dopa 250mg/8 hours PO- Cefadroxil 500mg/12 hours PO- Mefenamic acid 500mh/12 hours PO- Tubal ligation

NO ASSESMENTDr. Astri Widyastuti VALUE MAX Notes

1 Report technique 302 Paper acknowledgment 353 Honesty 35

Mean 100

OBSTETRICDr. Afan Novantri

- -

Gynaecology Chief on DutyWednesday, November 4th, 2015 03.30 PM – Thursday, November 5th, 2015 07.00 AM

Consultant on duty : dr. H. Rizal Sanif, SpOG (K)1. 5.11.15 Consult from Surgery Departement

Mrs.SRI/25/RA/AFN-RS 04.00 AM D/ Acute Appendicitis was suspected

Lab :Leu 18.00

PT (-)Alvorado score : 5

US Confirmation (PB):- Uterine shape and size was normal- Non-visualized both ovaries- There was Non- vascular mass at cavum duoglas

C/ Internal genitalia organ abnormality cannot be excluded yet

Suggestion : US abdomen10.30 AM Abdominal Ultrasound

C/ Perforatated appendicitis was suspectedM/ There is no specific treatment from Obgyn Departement Intraoperative consultation if there is abnormality finding during laparotomy

2. 5.11.15 Consult from Surgery Departement Mrs.RIA/25/RA/AFN-RS

04.00 AM D/ Acute Appendicitis was suspectedLab :

Leu 10.500

PT (-)Alvorado score : 3

US ER :- Uterine shape and size was normal- Both adnexa was normal

C/ There is no abnormality finding in genital interna organ

M/ There is no specific treatment from Obgyn Departement Other treatment according to Surgery Departement

NO ASSESMENTDr. Afan Novantri VALUE MAX Notes

1 Report technique 302 Paper acknowledgment 353 Honesty 35

Mean 100