Kematian Janin Dalam Rahim pada Kehamilan Aterm dengan Eklampsia, Partial Hellp Syndrome, Edema Paru Akut dan Syok Kardiogenik

Harvey Alvin Hartono, Indah Widya Astuti, Ario Danianto

Abstract


Tujuan: Melaporkan eklampsia, partial HELLP syndrome, edema paru akut sebagai komplikasi dari preeklampsia berat.
Metode: Laporan Kasus.
Hasil: Preeklampsia berat dan eklampsia merupakan penyebab kematian ibu berkisar 1.5-25 %, sedangkan kematian bayi antara 45-50 % di Indonesia.  Eklampsia adalah kelainan akut pada ibu hamil, persalinan, atau nifas ditandai kejang dan atau koma, dimana sebelumnya sudah menunjukkan gejala preeklampsia. Preeklampsia dan eklampsia memberi pengaruh buruk pada janin. Kami melaporkan kasus nulipara berusia 20 tahun dengan Kematian Janin Dalam Rahim + eklampsia + partial HELLP syndrome + Edema Paru + syok kardiogenik. Persalinan diakselerasi dengan forceps ekstraksi dan bayi lahir mati dengan Berat 2700g. Kesadaran pasien menurun dua jam post partum dan pasien tampak sesak. Pasien mengalami perbaikan selama perawatan dan dipulangkan pada hari ke 5.
Kesimpulan: Sindroma HELLP merupakan komplikasi preeklampsia dan eklampsia yang mengancam nyawa karena tingkat morbiditas dan mortalitas maternal serta perinatal yang tinggi. Diperlukan diagnosa dini dan intervensi tepat untuk mencegah perkembangan patofisiologi yang mengarah ke komplikasi.

Kata kunci: KJDR, Eklampsia, Partial HELLP syndrome, Edema Paru Akut


Abstract
Objective: To report eclampsia, HELLP syndrome, acute lung edema as complications of severe preeclampsia.
Methods: Case report.
Result: In Indonesia, severe preeclampsia and eclampsia are the causes of maternal mortality in the range of 1.5-25%, while infant mortality is between 45-50%. Eclampsia is an acute disorder in pregnant women, childbirth, or puerperium characterized by seizures and/ coma, which have previously shown symptoms of preeclampsia. It has negative influence on the fetus. We reported a case of 20 years old nulliparous with Intrauterine Fetal Death+eclampsia+partial HELLP syndrome+acute lung edema+cardiogenic shock. The labor accelerated by forceps extraction and 2700 grams stillbirth was born. Patient awareness decreased two hours post partum, she was short of breath. She was treated and her condition get improved then discharged on 5th day.
Conclusion: HELLP Syndrome is a severe variant complication of Preeclampsia and Eclampsia because of the level of maternal-perinatal morbidity is high. It needs early diagnosis and prompt treatment to arrest further progress leading to complications.   

Key words: IUFD, Eclampsia, Partial HELLP syndrome, Acute Lung Edema




Keywords


KJDR, eklamsia, Partial Hellp syndrome, Acute Lung Edema, Syok kardiogenik

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References


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DOI: http://dx.doi.org/10.24198/obgynia.v2n2s.132

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