cord prolapse
DESCRIPTION
obgynTRANSCRIPT
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P R O L A P S U S
T A L I
P U S A T Dr. BW PurnomoBag/SMF Obstetri & Ginekologi
RS Dokter Kariadi/FK UNDIP
Semarang 2006
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PENDAHULUAN
Meningkatkan morbiditas dan mortalitas
perinatal
Angka mortalitas bisa >15%
Angka kejadian pada kehamilan tunggal
0,1% sampai 0,5%
Berhubungan dengan kompresi pada
tali pusat yang berakibat timbulnya
gangguan sirkulasi maternal – fetal
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OVERT CORD PROLAPS
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FUNIC PRESENTATION/ PRESENTATION OF THE CORD
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OCCULT CORD PROLAPS
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FAKTOR PREDISPOSISI
1. Prematuritas (< 34 minggu)
2. Presentasi abnormal
3. Positio oksipitalis posterior
4. Tumor pelvis
5. Plasenta letak rendah
6. Kelainan bentuk panggul/ CPD
7. Polihidramnion
8. Ketuban pecah dini
9. Kelainan tali pusat
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TANDA dan GEJALA
Tali pusat menumbung dikenali dg terabanya tali pusat dalam vagina atau tampak diluar vulva. Disebut terkemuka saat kulit ketuban masih utuh
Disebut occult jika saat monitoring intrapartum terdapat deselerasi variabilitas
Janin mengalami hipoksia bahkan
berakhir kematian. Saat terjadi gawat
janin, air ketuban dapat terwarnai oleh
mekoneum
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PENGELOLAAN
UMUM
Oksigen 2 – 4 L/menit
KHUSUS Tali pusat tidak berdenyut
Tali pusat berdenyut
Inpartu Kala I
Inpartu Kala II
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KOMPLIKASIMaternalSesuai dengan komplikasi dari tindakan yang dipilih
NeonatalHipoksia, asidosis, kematian
PROGNOSISMaternalBaik
NeonatalBergantung pada lama dan jenis kompresi
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PENCEGAHAN
• USG – DOPPLER
• Monitoring DJJ intrapartum
• Amniotomi atas indikasi
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