Recovered File TB

8/19/2019 Recovered File TB

1/21

KEHAMILAN DENGAN TUBERKULOSIS

Vicky Chrystine N. Sianipar10610050052

Pembimbing :

Dr. Benyamin Rapa, SpOG

Kepni!e"n I#m$ Kebi%nn %n Pen&'i! Kn%$ngnPe"i(%e 1) O'!(be" * 12 De+embe" 2015


2/21

PENDAHULUAN

T$be",$#(+i+ -TB./ m+i men%i m+# 'e+e!n %i %$ni%emi'in $g !$be",$#(+i+ p% 'emi#n be"%+"'n %!3HO $m# 4ni! mi# %engn !$be",$#(+i+ %i 4i#& ASEANmen,pi 6500 '+$+

Se," g#(b# !e",!! b4 $m# 4ni! mi# %engn!$be",$#(+i+ +ebn&' 216000 '+$+ p% !$n 2011

T$be",$#(+i+ p% 'emi#n memp$n&i gejala klinis yangserupa %engn !$be",$#(+i+ p% 4ni! &ng !i%' mi#

T$be",$#(+i+ !i%' mempeng"$i 'emi#n %n 'emi#n!i%' mempeng"$i mni7e+!+i '#ini+ %n p"(g"e+i8i!+pen&'i! bi# %i!e"pi %engn "egimen 'em(!e"pi &ng !ep!%n %e'$!

TB. p% ib$ mi# bi+ + %i%p! p% n' &ng b"$ #i"

me+'ip$n ib$ !e# men%p!'n !e"pi


3/21

TUBERKULOSIS DANKEHAMILAN

De!e'+i TB. p% ib$ mi# me"$p'n # pen!ing%engn !$$n meng$"ngi "i+i'( +e"i$+ p% nin%n b&i b"$ #i" $n!$' i!$ %e!e'+i TB. p% ib$mi# me"$p'n # pen!ing p% peme"i'+nn!en!# ,"e

9'!(" * 7'!(" &ng mempeng"$i TB. :

L('+i pen&'i!

U+i 'emi#n S!!$+ gii ib$

A% !i%'n& pen&'i! pen&e"!


4/21

MANI9ESTASI TB.P% b&i b"$ #i" :

B&i #i" !i%' ,$'$p b$#n

Be"! b%n #i" "en%

Hep!(meg#i Demm

Dp! !e"#i! p% +! b&i #i" !$ m$ng'in $g'n !e"#i! +e!e# %$ +mpi !ingg mingg$ +e!e#

#i"


5/21

DIAGNOSIS TB. PADA KEHAMILAN

Dign(+i+ m$ng'in !e"#mb! %i!eg''n '"enmni7e+!+i '#ini+ &ng !i%' '+ !$ !e"!$!$p !$ge# p% 'emi#n

BIAKAN SPUTUM -p(+i!i7 p%/ : B!$' ;<

Pen$"$nn be"! b%n ;1<

Demm =0<

M#i+e %n #e# b!$' %" 1)< Tnp ge# 20


6/21

U>I TUBERKULIN-TUBER.ULIN SKIN TEST/

An!igen purifed protein derivative -PPD/ 'e'$!n +e%ng&i!$ 5 $ni! !$be",$#in

In!e"p"e!+i $i !$be"'$#in%inggp p(+i!i7 bi# : - American

Thoracic Society/Centers od Disease Control, 1))0/ In%$"+i ≥5 mm p% p+ien %engn HI? %engn gmb"n

"%i(g"@ !("'+ bn("m# '(n!' %engn '+$+ '!i7

In%$"+i ≥10 mm p% m+&"'! be"e'(n(mi #em !$

&ng memp$n&i pen&'i! &ng mening'!'n "i+i'(!$be",$#(+i+

In%$"+i ≥15 mm p% me"e' &ng !i%' memp$n& +!$7'!(" "i+i'(p$n


7/21


8/21

PEER!"S##N SP$%$B%# Sp$!$m %imbi# = '#i -+e4'!$ * pgi * +e4'!$/

%#m 4'!$ 2 "i %i!eg''n %engn&itemukannya kuman %B -BTA/

P% p"(g"m TB n+i(n# penem$n BTA me##$ipeme"i'+n %' mi'"(+'(pi+ me"$p'n%ign(+i+ $!m


9/21


10/21

9OTO THORA Ti%' #im %i#'$'n bi# peme"i'+n ini %i#'$'n

m' %p! %i#'$'n %engn mengg$n'nabdominal shielding

Bi# p% "%i(g"@ neg!i8e m' !e"pi !i%'%ipe"#$'n +mpi +e!e# me#i"'n bi+n&%ibe"i'n 'em(p"(@#'+i+ i+(nii% +e#m 1 !$n


11/21

PEMBERIAN TERAPI TUBERKULOSIS

Pembe"in peng(b!n &ng !ep! %# pembe"inp"(@#'+i+ %engn i+(nii% %n pi"i%('+in +e#m ) b$#n&ng %i m$#i p% !"ime+!e" 'e%$ 'emi#n

3ni! mi# &ng HI? neg!i8e +ebgin be+" pen$#i+mengn$"'n b4 !e"pi %i!$n% +mpi +e!e#me#i"'n -= * 6 b$#n p+,p"!$m/

Ui !$be",$#in p(+i!i7 +p$!$m BTA neg!i8e bi'n neg!i8e%n 7(!( !("'+ men$n$''n in@#!"!e !$ %n& '8i!+

i+(nii% "i7mpi+in e!mb$!(# %n pi"i%('+in -) b$#n/

9(!( !("'+ !e"#i! p"(+e+ pen&'i! &ng !e# men&emb$ (b+e"8+i p+ien


12/21

TATALAKSANA TUBER.ULOSISPADA KEHAMILAN

T!#'+n TB. p% 'emi#n !i%' be"be%%engn TB. !np 'emi#n n& + pe"#$%ipe"!i'n pembe"in OAT %p! menimb$#'ne7e' !e"!(geni' !e"%p nin

Se," $m$m !e"bgi !+ %$ &i!$ :

1 TB. A'!i7 : %i!e"pi %engn !i%' mempe"!imbng'n!"ime+!e" 'emi#n G(#(ngn $!m OAT +epe"!ii+(nii% -INH/ "i7mpi+in -RI9/ e!mb$!(# -2RHERH/

P% p(p$#+i %engn "i+i'( TB. !inggi %n %n&"e+i+!en (b! n!i TB. !inggi m' %i!mb'npi"inmi%


13/21

2 TB. #!en : P+ien %engn $i !$be",$#in p(+i!i7 %n+e," '#ini+ !i%' % !n% * !n% !e"%i!$be",$#(+i+ '!i7 Pembe"in !e"pi p% TB. #!enbi+n& %i!$n% +mpi 2 * = b$#n +e!e# 'e#i"n

P% p+ien &ng memp$n&i "i+i'( '(n!' %engnin%i8i%$ BTA p(+i!i7 %n in7e'+i HI? !e"pi %ibe"i'n+e!e# !"ime+!e" pe"!m

Ti%' meme"#$'n !e"pi p"(@#'+i+ i+(nii% -=00mg +e#m 6 C 12 b$#n/


14/21

OBAT ANTITUBERKULOSISOb! #ini pe"!m -frst line/:

R!'#P!S!N (R!') D(+i+ : 10 mg'gBB +e"i +e'#i mim$m ;50mg"i

Be'e" p% +e# &ng +e%ng !$mb$ -in!" %n e'+!" +e#/

!e!pi $g mempe"#i!'n e7e' p% +e# &ng +e%ng !i%''!i7 -resting cell/

Memp$n&i me'ni+me post antibiotic eect !e"%p b'!e"ig"m neg!i7

E'E" S#P!NG :

Hep!(!('+i' Sin%"(m '$#i! +epe"!i g!# 'eme"n +in%"(m F$

be"$p %emm menggigi# n&e"i !$#ng %n +in%"(m pe"$! be"$pn&e"i pe"$! m$# m$n! %n '%ngC'%ng %i"e

!emmorrhagic disease o the ne"born +eingg %in$"'npembe"in p"(@#'+i+ 8i!min K


15/21

!SON!#*!D (!N+) D(+i+ 5 mg'gBB +e"i +e'#im =00 mg"i

Be"+i7! b'!e"i+i% %p! memb$n$ )0< p(p$#+i'$mn be'e" mengmb! bi(+in!e+i+ +m mi'(#!&ng me"$p'n $n+$" pen!ing %in%ing +e##ycobacterium

I+(nii% !i%' be"+i7! !e"!(geni' nin me+'ip$n'(n+en!"+i &ng me#e4!i p#+en! ,$'$p be+"

E'E" S#P!NG

Tn% 'e",$nn p% +"7 !epi 'e+em$!n n&e"i

(!(! !$ gngg$n 'e+%"n Te"pi : pembe"in piri&ksin -%engn %(+i+ 5C10 mg

pe" "i !$ %engn 8i!min B '(mp#e'+/


16/21

E%#B$%O- (EB) D(+i+: 15 mg'gBB +e'#i+e"i

Hn& '!i7 !e"%p +e# &ng be"!$mb$ %engn'+i! !$be"'$#(+!!i'

Me"$p'n inibi!(" arabinosyl transerases-IIIIII/ $n+$" e+en+i# %"i %in%ing +e#

#ycobacterium men&ebb'n me!b(#i+me +e#!e"mb! %n +e# m!i +eingg '$mn !i%'%p! !$mb$ %i !$b$ penm$

E!mb$!(# !i%' e7e'!i7 $n!$' '$mn #in

E'E" S#P!NG

Gngg$n peng#i!n -+ebi'n& !e"pi %ien!i'n/


17/21

P!R#*!N#!D (P*#) D(+i+ : 25 mg'gBB +e'#i+e"i m 2000 mg +e"i

PA meme"#$'n '(n8e"+i enim pi"inmi%+e-%i+i#'n (#e mi'(b'!e"i# !e"!en!$/ men%i ben!$''!i7 +m pi"in(! m+$' 'e %#m +i!(p#+m #$tuberculosis +e," %i7$+i p+i7

PA be'e" bi' p% pH &ng "en% !i%' be'e"p% 'e%n %("mn

Ti%' %n& %! &ng %e'$! mengeni e7e'!e"!(geni'n&

E'E" S#P!NG

Hep!i!i+ n&e"i +en%i %n +e"ngn "!"i!i+ g($! &ng'em$ng'inn %i+ebb'n be"'$"ngn& e'+'"e+i %npenimb$nn +m $"!


18/21

S%REP%O!S!N D(+i+ +!"ep!(mi+in 05 C 1g"i +e#m 1; * 21 "i +e#n$!n& 1g = '#i

+emingg$ IM

Me#e4!i p#+en! %engn ,ep! +mpi 'e+i"'$#+i nin %n ,i"n

E'E" S#P!NG

Ottksisiti.

%uli kngenital telah &ilaprkan terja&ipa&a /ayi &ng !e"pn +e#m %#m'n%$ngn


19/21


20/21

Second %ine Drug :

"#N#!S!N D(+i+ &ng %ibe"i'n 15 mg'g BB

%ibe"i'n =C5 '#i +emingg$ IM Ti%' %ig$n'n p% 'emi#n 'e,$#i p% MDR

E7e' +mping &ng +m %engn +!"ep!(mi+in

E%!ON#!D D(+i+ 05 C 1 g"m"i

Memp$n&i pene!"+i &ng bi' 'e +em$ "ingn!e"m+$' ,i"n +e"eb"(+pin#

Be"+i7! !e"!(geni' %n +ebi'n& %iin%"ipengg$nn p% 'emi#n 'e,$#i i'

%ib$!$'n p% '+$+ MDRCTB

"#PREO!S!N D(+i+ &ng %ibe"i'n 05 C 1g"m"i +e#m 2C6 b$#n +e#n$!n& 1 g"m = '#i+emingg$ IM

Diig$n'n $n!$' MDRCTB


21/21

THANK OU

Recovered File TB

Documents

Transcript of Recovered File TB