Complete Placenta Previa at 39 Weeks Gestation on Multiparous and Two Times History of Caesarean Section with Complication of Post Partum Haemorrhage and Hypovolemic Shock

Reski Wulandari Roni,(1*) Ferri Waluyo Wiwoho Pujojati,(2)

(1) Rumkit Tk II Dr R Hardjanto Balikpapan
(2) Rumkit Tk II Dr R Hardjanto Balikpapan
(*) Corresponding Author

Abstract


Penyebab Angka Kematian Ibu (AKI) yang utama ialah perdarahan. Di Indonesia, menurut Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2012, AKI di Indonesia masih tinggi sebesar 359 per 100.000 kelahiran hidup. Berdasarkan data tahun 2010-2013 penyebab kematian terbesar kematian ibu ialah perdarahan.  Plasenta previa merupakan salah satu penyebab perdarahan yang tersering terjadi pada ibu hamil.
Tujuan dari penulisan laporan kasus ini adalah memahami komplikasi dari plasenta previa yaitu perdarahan pasca salin dan bagaimana tatalaksana kasus tersebut. Kami melaporkan kasus mengenai seorang wanita 31 tahun dengan plasenta previa totalis pada usia kehamilan 39 minggu. Pasien memiliki riwayat dua kali seksio sesaria sebelumnya. Didapatkan perdarahan pasca salin saat dilakukan seksio sesaria disertai syok hipovolemik. Komplikasi yang disebabkan oleh letak plasenta yang rendah adalah perdarahan pasca salin yang terjadi selama pembedahan. Perkiraan jumlah kehilangan darah sebanyak 2500 cc, dan didapatkan hemoglobin 1,8 g%. Kondisi hemodinamik tidak stabil dengan tekanan darah 80/50 mmHg, dan kesadaran pasien mulai menurun. Kondisi pasien membaik 3 hari pasca operasi dengan monitoring ketat di Unit Perawatan Intensif  (ICU).

Total Placenta Previa with Complication of Post Partum Haemorrhage
at 39 Weeks Gestation on Multiparous

Abstract
The main cause of maternal mortality (MMR) is bleeding. In Indonesia, according to the 2012 Indonesian Demographic and Health Survey (IDHS), the maternal mortality rate in Indonesia is still high at 359 per 100,000 live births. Based on data in 2010-2013 the biggest cause of maternal death is bleeding. Placenta previa is one of the most common causes of bleeding in pregnant women.  
The purpose of writing this case report is to understand the complication of placenta previa, post partum hemorrhage, and how to manage this case. We report the case of a 31-year-old woman with total placenta previa at 39 weeks' gestation with a history of previous cesarean section two times presenting with postpartum haemorrhage during cesarean section. The patient was found with hypovolemic shock. The estimated blood loss of the patient was 2500 cc and the patient's hemoglobin was 1.8 g%. The patient's blood pressure dropped to 80/50 mmHg, and the patient's consciousness was disturbed. The patient's condition improved 3 days after surgery and close monitoring in the Intensive Care Unit (ICU).

Key word : Total Placenta Previa, Post Partum Haemorrhage.


Keywords


Complete Placenta Previa, Two Times History of Caesarean Section, Post Partum Haemorrhage, Hypovolemic Shock

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DOI: http://dx.doi.org/10.24198/obgynia/v5n1.275

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