130335918 preterm term posterm
TRANSCRIPT
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WHO, 1979, MEMBAGI UMUR KEHAMILAN ATAS :WHO, 1979, MEMBAGI UMUR KEHAMILAN ATAS :
Pre TermPre Term : < 37 minggu ( < 259 hari ) : < 37 minggu ( < 259 hari )
TermTerm : 37 - < 42 minggu (259 -293 hari) : 37 - < 42 minggu (259 -293 hari)
Post termPost term : > 42 minggu ( > 294 hari) : > 42 minggu ( > 294 hari)
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1)1) BBLR (Berat Badan Lahr Rendah)BBLR (Berat Badan Lahr Rendah)
a.a. Preterm / SM (Sesuai untu! Masa ehami"an)Preterm / SM (Sesuai untu! Masa ehami"an)
## "ahir sesuai $engan umur !ehami"an $iantara## "ahir sesuai $engan umur !ehami"an $iantara
%&th ' 9&th ersenti"es.%&th ' 9&th ersenti"es.
.. M (e*i" untu! Masa ehami"an) / P+TM (e*i" untu! Masa ehami"an) / P+T
(Pertumuhan +anin Ter"amat)(Pertumuhan +anin Ter"amat)
## "ahir ren$ah $ari ## seenarn,a ( < %&th## "ahir ren$ah $ari ## seenarn,a ( < %&therenti"es)erenti"es)
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!)!) BMK (Be"ar #nt#$ Ma"a Keha%&an)BMK (Be"ar #nt#$ Ma"a Keha%&an)
## "ahir > $ari ## umur !ehami"an seenarn,a## "ahir > $ari ## umur !ehami"an seenarn,a
( > 9&th ersenti"es).( > 9&th ersenti"es).
'ad BB ann $#ran dar !*++r tda$ "e%#a'ad BB ann $#ran dar !*++r tda$ "e%#a
re%at#re (re ter%) ta %#n$n KMK - .'T/re%at#re (re ter%) ta %#n$n KMK - .'T/
Secara Klinik,umur kehamilan ditentukan :Secara Klinik,umur kehamilan ditentukan : BB &ahr, anan 0adan,r#%2eren"a 3t34BB &ahr, anan 0adan,r#%2eren"a 3t34
2r3nta&"/2r3nta&"/ Met3de Ba&&ar d$$ 5 Men#na$an rteraMet3de Ba&&ar d$$ 5 Men#na$an rtera
h6"a& %at#rt6 dan ne#r3%#"#&ar %at#rt6h6"a& %at#rt6 dan ne#r3%#"#&ar %at#rt6
"$3re/"$3re/
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ura ertumuhan anin inutero
(#attag"ia 0uhen*o)
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Ma!in ren$ah umur gestasi a$a ersa"inan1 ma!inMa!in ren$ah umur gestasi a$a ersa"inan1 ma!in !e*i" ## a,i $i"ahir!an $an ma!in tinggi mori$itas!e*i" ## a,i $i"ahir!an $an ma!in tinggi mori$itas
$an morta"itas.$an morta"itas.
In"den" 41+8In"den" 41+8
AKTOR .REIS.OSISIAKTOR .REIS.OSISI1)1) I0#I0#
#1 e"ainan uterus1 eri 6n!oeten#1 e"ainan uterus1 eri 6n!oeten Ma"nutrisi1 68 $engan !ehami"an1 Pen,a!it-Ma"nutrisi1 68 $engan !ehami"an1 Pen,a!it-
en,a!it a!ut1 8M1 iertensien,a!it a!ut1 8M1 iertensi 6ntera" !ehami"an en$e!6ntera" !ehami"an en$e! 6ne!si sa"uran !en*ing1 genita"ia $an intra uterin.6ne!si sa"uran !en*ing1 genita"ia $an intra uterin. 6n$u!si artus e"e!ti1 trauma6n$u!si artus e"e!ti1 trauma Primi mu$a/tua1 !e"ainan imun$o"ogi (rhesus)Primi mu$a/tua1 !e"ainan imun$o"ogi (rhesus)
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!)!) a$t3r 'ann dan .&a"entaa$t3r 'ann dan .&a"enta
;aat 0a<aan;aat 0a<aan Ha%& $e%0ar = hdra%n3nHa%& $e%0ar = hdra%n3n
Ket#0an eah dn, endarahan Anteart#%Ket#0an eah dn, endarahan Anteart#%(&/re>a, "3& &a"enta, >a"a re>a)/(&/re>a, "3& &a"enta, >a"a re>a)/
?)?) S3"a& e$3n3% rendahS3"a& e$3n3% rendah
@)@) Ke0a"aan : $era 0erat, %er3$3$Ke0a"aan : $era 0erat, %er3$3$
*)*) Tda$ d$etah#Tda$ d$etah#
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.ENANGANAN.ENANGANAN
.en30atan $a#"a&.en30atan $a#"a& hin$ari en,ea-en,ea ersa"inan retermhin$ari en,ea-en,ea ersa"inan reterm engoatan $an eraatan sangat !husus $anengoatan $an eraatan sangat !husus $an
maha".maha".
B&a t%0#& HIS :B&a t%0#& HIS :
8aat $ieri!an T06S6S misa"n,a :8aat $ieri!an T06S6S misa"n,a : 6souine ($ua$i"an)6souine ($ua$i"an) Sa"utamo" (ento"in)Sa"utamo" (ento"in) Teruta"in (ri*asma)1 $""Teruta"in (ri*asma)1 $""
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.e%atanan ar# :.e%atanan ar# : K3rt$3"ter3dK3rt$3"ter3d 4 0eta%eta"3n4 0eta%eta"3n
4 de$"a%eta"3n4 de$"a%eta"3n
B&a er&# d0er$an ant0t$aB&a er&# d0er$an ant0t$a
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.enananan .er"a&nan.enananan .er"a&nan
ert%0an$an :ert%0an$an :
1)1) Ke%a%#an $&n$ d3$ter #nt#$ %era<at 0a6Ke%a%#an $&n$ d3$ter #nt#$ %era<at 0a6.reter%/.reter%/
!)!) .&han .er"a&nan 6an ter0a$.&han .er"a&nan 6an ter0a$
4 er>ana%4 er>ana%
4 S;4 S;
?)?) .endaat a"en dan $e&#ara ata" $3n"e$#en".endaat a"en dan $e&#ara ata" $3n"e$#en"era<atan 0a6 reter% dan $e%#n$nan hd#era<atan 0a6 reter% dan $e%#n$nan hd#
ata# aat/ata# aat/
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K3%&$a" .er"a&nan .reter% :K3%&$a" .er"a&nan .reter% :
K3%&$a" an$a ende$ :K3%&$a" an$a ende$ :
RRSS, endarahan 3ta$, Ner3tn Enter3 ;3&t", endarahan 3ta$, Ner3tn Enter3 ;3&t"(NE;), $e&anan ar# .aten #$t#" Arter3"#" dan(NE;), $e&anan ar# .aten #$t#" Arter3"#" danSe""/Se""/
K3%&$a" an$a anan :K3%&$a" an$a anan :
44 Ke&anan ne#r3&3"t "ere0ra& a&"/Ke&anan ne#r3&3"t "ere0ra& a&"/
4 retn3at dan ertarda" %enta&/4 retn3at dan ertarda" %enta&/
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.'T.'T .ert#%0#han 'ann Ter&a%0at.ert#%0#han 'ann Ter&a%0at
KMK Ke& #nt#$ Ma"a Keha%&anKMK Ke& #nt#$ Ma"a Keha%&an
e2en"e2en" #i"a $itemu!an erat a$an anin !urang $ari %#i"a $itemu!an erat a$an anin !urang $ari %&th;&th;
$ari usia !ehami"an tertentu.$ari usia !ehami"an tertentu.
SINONIM :SINONIM :UGR, S%a&& 23r date", 6"%at#rta", eta& Ma&n#trt3nUGR, S%a&& 23r date", 6"%at#rta", eta& Ma&n#trt3nS6ndr3%e, ;hr3n eta& "tre"", S%a&& 23r Ge"tat3na& AeS6ndr3%e, ;hr3n eta& "tre"", S%a&& 23r Ge"tat3na& Ae(SGA)(SGA)
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6sti"ah ini !urang teat !arena a$a 25-&; ,ang er!aitan6sti"ah ini !urang teat !arena a$a 25-&; ,ang er!aitan
$engan !onstitusi etni! $an esar orang tua.$engan !onstitusi etni! $an esar orang tua.
=ng!a resi!o !ematian - %& !a"i "eih tinggi $ari a,i =ng!a resi!o !ematian - %& !a"i "eih tinggi $ari a,inorma".norma".
8i +a!arta ertumuhan anian ter"amat :8i +a!arta ertumuhan anian ter"amat :- e!onomi ren$ah !urang "eih %4 ;- e!onomi ren$ah !urang "eih %4 ;
- e!onomi menengah atas 5 ;.- e!onomi menengah atas 5 ;.
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1)1) Te .r33r"3na& (Te S%etr")Te .r33r"3na& (Te S%etr")
+anin men$erita $istress sea! "ama (8M1 iertensi).+anin men$erita $istress sea! "ama (8M1 iertensi).
Panang a$an "ing!aran !ea"a $a"am roorsi seimang1 tetaiPanang a$an "ing!aran !ea"a $a"am roorsi seimang1 tetai
masih $iaah u!uran masa gestasi seenarn,a.masih $iaah u!uran masa gestasi seenarn,a.
!)!) Te "r33r"3na& (Te A"%etr")Te "r33r"3na& (Te A"%etr")
+anin men$erita $istress sua!ut1 eeraa minggu/hari+anin men$erita $istress sua!ut1 eeraa minggu/hari
see"um "ahir.see"um "ahir.Panang a$an1 "ing!aran !ea"a norma" "ing!aran erut auhPanang a$an1 "ing!aran !ea"a norma" "ing!aran erut auh
"eih !e*i" $an ## < $ari masa gestasi seenarn,a."eih !e*i" $an ## < $ari masa gestasi seenarn,a.
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A/A/ a$t3r I0#a$t3r I0#
iertensi1 en,a!it gina" !roni! $an P?iertensi1 en,a!it gina" !roni! $an P?
Pero!o!1 @ar!oa1 ="!oho"Pero!o!1 @ar!oa1 ="!oho"
8M ,ang erat1 en,a!it antung8M ,ang erat1 en,a!it antung
ioia a$a iu (tingga" $i egunungan1 en,a!it aruioia a$a iu (tingga" $i egunungan1 en,a!it aru
!roni!1 =sma)!roni!1 =sma)
S0? (Sistemi! 0uus ?ritromatosus)S0? (Sistemi! 0uus ?ritromatosus)
B/B/ a$t3r Uter#" dan .&a"entaa$t3r Uter#" dan .&a"enta e"ainan emu"uh $arah1e"ainan emu"uh $arah1
6nsersi ta"i usat ti$a! norma"6nsersi ta"i usat ti$a! norma"
terus i*ornis 1 6nar! "asentaterus i*ornis 1 6nar! "asenta
Seagian "asenta "easSeagian "asenta "eas
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;/;/ a$t3r 'anna$t3r 'ann
emaremar
e"ainan !romosome"ainan !romosom
a*at aaana*at aaan
6ne!si $a"am !an$ungan ("ues1 TA)6ne!si $a"am !an$ungan ("ues1 TA)
// .en6e0a0 Lan.en6e0a0 Lan Sosia" e!onomi ren$ahSosia" e!onomi ren$ah
Ti$a! $i!etahuiTi$a! $i!etahui
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K&n"K&n" B 3*m "eih ren$ah $ari tua !ehami"anB 3*m "eih ren$ah $ari tua !ehami"an
seenarn,a harus $i *urigai (iasan,aseenarn,a harus $i *urigai (iasan,a
sete"ah !ehami"an 2Cmg). sete"ah !ehami"an 2Cmg).
USGUSG $aat "eih $ini $engan emeri!saan seri$aat "eih $ini $engan emeri!saan seri
(seai!n,a $ari umur 2&mg s/$ 32-34mg). (seai!n,a $ari umur 2&mg s/$ 32-34mg).
8aat $i*urigai:8aat $i*urigai:
- a$an,a !e"ainan arus $arah =.um"i!a"is1- a$an,a !e"ainan arus $arah =.um"i!a"is1 =.sira"is $an =.utrine. =.sira"is $an =.utrine.
- i"a a$a o"igohi$ramnion.- i"a a$a o"igohi$ramnion.
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.erenanaan KMK, en30atan $a#"a&/.erenanaan KMK, en30atan $a#"a&/ .ada #%#%n6a %at#rta" KMK n "e"#a denan.ada #%#%n6a %at#rta" KMK n "e"#a denan
%a"a e"ta"n6a/%a"a e"ta"n6a/ .era<atan $h#"#"/.era<atan $h#"#"/
.r3n3"e .'T.r3n3"e .'T Tergantung $ari erat ringann,a masa"ahTergantung $ari erat ringann,a masa"ah
erinata".erinata". Ma!in ren$ah masa gestasi/ma!in ren$ah ##Ma!in ren$ah masa gestasi/ma!in ren$ah ##
a,i1= ma!in tinggi $an ma!in tinggia,i1= ma!in tinggi $an ma!in tinggi!om"i!asi $i!emu$ian hari!om"i!asi $i!emu$ian hari(tu"i1uta1gangguan sara usat1 $"").(tu"i1uta1gangguan sara usat1 $"").
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BMK ( Be"ar #nt#$ Ma"a Keha%&an)BMK ( Be"ar #nt#$ Ma"a Keha%&an)
##0 > $ari ## umur !ehami"an seenarn,a##0 > $ari ## umur !ehami"an seenarn,a
(>9&th ersenti"e).(>9&th ersenti"e).
Et3&3 :Et3&3 :
44 Genet$Genet$
4 M ( M Ge"ta"3na& dan M rnan "edan)4 M ( M Ge"ta"3na& dan M rnan "edan)
.er"a&nan : d"t3"a.er"a&nan : d"t3"a
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e2n"e2n"
tua !ehami"antua !ehami"an >> 42 minggu atau42 minggu atau >> 294294
harihari
Bre!uensiBre!uensi DD %&; (315; -%4;)%&; (315; -%4;)
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Menentukan Tua KehamilanMenentukan Tua Kehamilan
H#$#% Nae&e5 $e"#&tan ada&ah 5H#$#% Nae&e5 $e"#&tan ada&ah 5
DD %&; iu "ua hai$ tera!hir %&; iu "ua hai$ tera!hir
Su"it menentu!an hari teat saat ou"asi.Su"it menentu!an hari teat saat ou"asi.
enan USG ada ha%& 411 %n#5 $e"a&ahanenan USG ada ha%& 411 %n#5 $e"a&ahan
CC 7 har7 har
Ha%r !!8 dan3"e tda$ daat dtea$$an/Ha%r !!8 dan3"e tda$ daat dtea$$an/
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ETIOLOGIETIOLOGI
Be&#% d$etah# denan e&a"Be&#% d$etah# denan e&a"
Be0eraa te3r da#$an :Be0eraa te3r da#$an :
1)1) .r3e"ter3n.r3e"ter3n
4 $3n"entra" %eneta4 $3n"entra" %eneta
!)!) Te3r O$"t3"nTe3r O$"t3"n
4 e&ea"an 3$"t3"n $#ran ada $eha%&an4 e&ea"an 3$"t3"n $#ran ada $eha%&an
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?)?) Te3r K3rt"3& - A;TH 'annTe3r K3rt"3& - A;TH 'ann.enn$atan t0a4t0a $adar $3t"a& ada ann.enn$atan t0a4t0a $adar $3t"a& ada ann::
Memengaruhi "asentaMemengaruhi "asenta
Penurunan rogesteronePenurunan rogesterone
Pening!atan rostag"an$inPening!atan rostag"an$in is is
@)@) Sara2Sara2 ##ter#"ter#" Pene!anan a$a "eus ran!enPene!anan a$a "eus ran!en
hausehause
5)5) Heredter Heredter
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Akibat pada janin Akibat pada janin
1)1) 'ann t#%0#h ter#" da&a% rah%'ann t#%0#h ter#" da&a% rah%
## ertamah## ertamah
Su"it artus (P8)Su"it artus (P8)
!)!) .ert#%0#han ann 0erhent ("ndr3%a 3"%at#rta").ert#%0#han ann 0erhent ("ndr3%a 3"%at#rta")
BB %eneta 0ah$an %en#r#n %atBB %eneta 0ah$an %en#r#n %at
Ke&ananKe&anan Stad#% IStad#% I Kulit kehilangan vermi Kulit kehilangan vermi ksks
kaseosa dan maserasi berupa kulit kering, rapuhkaseosa dan maserasi berupa kulit kering, rapuh
dan mudah terkelupasdan mudah terkelupas
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Stad#% IIStad#% II Gejala stadium I ditambahGejala stadium I ditambah
mekonium (kehijauan) pada kulit.mekonium (kehijauan) pada kulit.
Stad#% IIIStad#% III Disertai pewarnaanDisertai pewarnaan
kekuningan pada kuku, kulit dan tali pusat.kekuningan pada kuku, kulit dan tali pusat.
S$a $3n"er>at2 ada 3"t ter% %ena$0at$anS$a $3n"er>at2 ada 3"t ter% %ena$0at$an
$e%atan ernata& %enn$at (+4!!8) har#"$e%atan ernata& %enn$at (+4!!8) har#"dtent#$an $eadaan ann/dtent#$an $eadaan ann/
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Penentuan Keadaan Pada JaninPenentuan Keadaan Pada Janin
a)a) N3n "tre"" te"t-"tre"" te"t/N3n "tre"" te"t-"tre"" te"t/0)0) Gera$an ann (7-!+) "#0e$t2 denan t3$3ra2Gera$an ann (7-!+) "#0e$t2 denan t3$3ra2
1+-!+1+-!+ ..
)) D3&#%e ar $et#0an5D3&#%e ar $et#0an5
A%n3"$3A%n3"$3 : 0&a "ed$t C %e3n#%: 0&a "ed$t C %e3n#%"tan (C)"tan (C) re"$3 a"2$"a ??8/ re"$3 a"2$"a ??8/
USGUSG : ar $et#0an "ed$t 0&a ter&hat : ar $et#0an "ed$t 0&a ter&hat
1%/1%/
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Penanganan PersalinanPenanganan Persalinan
1)1) Ha"& te"t (C) en#r#nan 2#n" &a"entaHa"& te"t (C) en#r#nan 2#n" &a"enta
S;S;
!)!) Te"t (4) :Te"t (4) :
B3&eh t#n# 1 %n# &an"#nB3&eh t#n# 1 %n# &an"#n
nd#$"nd#$"
.ena<a"an denan $etat.ena<a"an denan $etat B&a ada tanda d"tre"" S;B&a ada tanda d"tre"" S;
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Penanganan Pada Bayi Penanganan Pada Bayi
1)1) Re"#"ta" a$t2 0&a e<arnan %e$3n#% 3"t2/Re"#"ta" a$t2 0&a e<arnan %e$3n#% 3"t2/
!)!) B&a %e$3n#% $enta& nt#0a" danB&a %e$3n#% $enta& nt#0a" dan
e%0er"han trahea C O!/e%0er"han trahea C O!/
?)?) Ba6 denan 3"t %at#rta" "ern %enderta :Ba6 denan 3"t %at#rta" "ern %enderta :
h3>3&e%ah3>3&e%a
h63Fah63Fa
ad3""ad3""
h3rte%ah3rte%a
h3&$e%ah3&$e%a h32#n" adrena&h32#n" adrena&
%e%er&#$an tnda$an 6an ade$#at/%e%er&#$an tnda$an 6an ade$#at/
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