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    Atonia Uteri

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    Darra Kurniasari
    The document discusses postpartum hemorrhage prevention and treatment. It outlines several risk factors for atony including maternal anemia, prolonged labor, and large baby size. It recommends the following six steps: 1) Start IV fluids for all deliveries. 2) Administer uterotonic drugs like ergometrin and oxytocin. 3) Controlled cord traction. 4) Uterine massage. 5) Evaluate for causes of bleeding like poor tone or lacerations. 6) Prepare for referral in case of emergency, including establishing transfer protocols.

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    © All Rights Reserved
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    Atonia Uteri

    Uploaded by

    Darra Kurniasari
    52 views22 pages
    The document discusses postpartum hemorrhage prevention and treatment. It outlines several risk factors for atony including maternal anemia, prolonged labor, and large baby size. It recommends the following six steps: 1) Start IV fluids for all deliveries. 2) Administer uterotonic drugs like ergometrin and oxytocin. 3) Controlled cord traction. 4) Uterine massage. 5) Evaluate for causes of bleeding like poor tone or lacerations. 6) Prepare for referral in case of emergency, including establishing transfer protocols.

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    PPT ATONIA UTERI. KEGAWATDARURATAN

    Original Title

    ATONIA UTERI

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    The document discusses postpartum hemorrhage prevention and treatment. It outlines several risk factors for atony including maternal anemia, prolonged labor, and large baby size. It recommends the following six steps: 1) Start IV fluids for all deliveries. 2) Administer uterotonic drugs like ergometrin and oxytocin. 3) Controlled cord traction. 4) Uterine massage. 5) Evaluate for causes of bleeding like poor tone or lacerations. 6) Prepare for referral in case of emergency, including establishing transfer protocols.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    52 views22 pages

    Atonia Uteri

    Uploaded by

    Darra Kurniasari
    The document discusses postpartum hemorrhage prevention and treatment. It outlines several risk factors for atony including maternal anemia, prolonged labor, and large baby size. It recommends the following six steps: 1) Start IV fluids for all deliveries. 2) Administer uterotonic drugs like ergometrin and oxytocin. 3) Controlled cord traction. 4) Uterine massage. 5) Evaluate for causes of bleeding like poor tone or lacerations. 6) Prepare for referral in case of emergency, including establishing transfer protocols.

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    ATONIA UTERI

    DR DODI HENDRADI, SPOG


    RS IMANUEL LAMPUNG
    MENGENALI FAKTOR RESIKO
    • IBU:
    – Anemia
    – Partus lama
    – Hiperekstensi uterus
    – Induksi persalinan
    – Preeklampsia
    • BAYI:
    – Bayi besar / gemeli
    ANGGAP SEMUA PERSALINAN
    BERESIKO ATONIA !!!
    LANGKAH 1: PASANG INFUS PADA
    SEMUA PERSALINAN
    • RL
    • NaCl 0.9 %
    • Jarum infus no 16 – 18
    LANGKAH 2 : UTEROTONIKA
    • Ergometrin 0.2 mg (1 ampul) intravena
    • Oksitosin 10 unit im atau dalam RL drip
    • Oksitosin + ergometrin (dalam RL drip)
    • Misoprostol 3 tab / rektal
    LANGKAH 3 : PEREGANGAN TALI
    PUSAT TERKENDALI
    MANUAL PLASENTA
    APAKAH LENGKAP ???
    LANGKAH 4 : KOMPRESI UTERUS
    LANGKAH 5 : EVALUASI PENYEBAB
    PERDARAHAN
    • Tonus otot ?
    • Robekan jalan lahir ?
    • Gangguan pembekuan darah ?
    • Sisa plasenta ?
    LANGKAH 6 : PERSIAPAN RUJUK
    • Terpasang infus
    • Ditemani bidan perujuk
    • Buat sistem rujukan dengan RS terkait
    • Kasus : jampersal – Jamkesda – Jamkesmas –
    Pribadi (???)
    PENGGUNAAN KONDOM
    • Under aseptic precautions a sterile rubber catheter was inserted within the condom and tied near
    the mouth of the condom by a silk thread.
    • Urinary bladder was kept empty by indwelling Foley's catheter.
    • After putting the patient in the lithotomy position, the condom was inserted within the uterine
    cavity.
    • Inner end of the catheter remained within the condom.
    • Outer end of the catheter was connected with a saline set and the condom was inflated with 25-
    500 mL of running normal saline.
    • Bleeding was observed, and when it was reduced considerably, further inflation was stopped and
    the outer end of the catheter was folded and tied with thread.
    • Uterine contraction was maintained by oxytocin drip for at least 6 hours after the procedure.
    • The uterine condom was kept tight in position by ribbon gauze pack or another inflated condom
    placed in the vagina.
    • The condom catheter was kept for 24-48 hours and then was deflated gradually over (10-15
    minutes) and removed.
    • Patient was kept under triple antibiotic coverage (amoxicillin [500 mg every 6 hrs] + metronidazole
    [500 mg every 8 hrs] + gentamicin [80 mg every 8 hrs]) administered intravenously for 7 days.
    INVERSIO UTERI
    • Definisi : keadaan dimana lapisan dalam
    uterus (endometrium) turun dan keluar lewat
    ostium uteri eksternum
    • Bersifat komplit dan inkomplit
    • Tanda : syok, perdarahan, kesakitan, tampak
    endometrium (atau plasenta) terbalik
    INVERSI UTERI
    PENANGANAN INVERSIO UTERI
    • Reposisi segera
    • Pasang tampon uterovaginal
    • Uterotonika
    • Rujuk
    • Pasang kateter tetapi
    KURETASE PASCA PERSALINAN

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