Penanganan Kasus Kehamilan 32 Minggu dengan Hipertiroid Janin-Fetal Goiter

Anggy Albernande, Muhammad Al Farisi Sutrisno, Peby Maulina Lestari, Rose Mafiana, Yulianto Kusnadi, Indrayadi Indrayadi, Aditiawati Aditiawati


Abstract


Hipertiroid pada kehamilan didefinisikan sebagai peningkatan kadar free T4. Hipertiroid terjadi pada 2/1000 kehamilan yaitu hipertiroid yang tidak terkontrol selama kehamilan meningkatkan risiko krisis tiroid, kelahiran prematur, dan kematian janin. Pasien Ny. DK 21 tahun datang dengan keluhan benjolan di leher kanan sebesar telur puyuh, hamil 21 minggu, dengan hasil USG fetal goiter. Pemeriksaan fisik didapatkan keadaan umum baik, suhu 36,60C; tekanan darah: 120/80 mmHg; frek. nadi: 92x/menit; frek. nafas: 20 x/menit. Pada pemeriksaan Leopold I didapatkan tinggi fundus uteri 21 cm, teraba bagian lunak. Leopold II teraba tahanan memanjang di sisi kiri kesan punggung. Leopold III teraba bagian terbawah bulat, melenting dan keras U 5/5, kesan kepala. DJJ 159x/mnt, TBJ 1240 gram. Pada pasien dilakukan observasi dan kontrol dengan rentang 2 minggu setelah pemeriksaan. Tata laksana pada pasien ini adalah asam folat, kalsium karbonat, vitamin D, propylthiouracil, folamil, dan ferrous sulfat.

Management of Cases 32 Weeks Gestational Pregnancy with Fetal Hyperthyroidism-Fetal Goiter

Abstract
Hyperthyroidism in pregnancy is defined as an increase in free T4 levels. Hyperthyroidism occurs in 2/1000 pregnancies where uncontrolled hyperthyroidism during pregnancy increases the risk of thyroid crisis, premature birth and fetal death. Patient Mrs. 21 year old DK came with complaints of a lump in her right neck the size of a quail egg, 21 weeks pregnant, with ultrasound results of fetal goiter. Physical examination revealed good general condition, temperature 36.60C; blood pressure: 120/80 mmHg; Strange. pulse: 92x/minute; Strange. breath: 20 x/minute. On examination by Leopold I, the height of the uterine fundus was 21 cm, and the soft part was palpable. Leopold II has a longitudinal resistance on the left side of the dorsal impression. Leopold III palpable lower part round, melted and hard U 5/5, head impression. DJJ 159x/minute, TBJ 1240 grams. Patients were observed and monitored at intervals of 2 weeks after the examination. Treatment for this patient is folic acid, calcium carbonate, vitamin D, propylthiouracil, folamyl and ferrous sulfate.

Key words: Hyperthyroidism, fetal goiter, propylthiouracil


Keywords


Hipertiroid, fetal goiter, propylthiouracil

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References


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DOI: http://dx.doi.org/10.24198/obgynia.v7i1.609

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