Algoritme Perdarahan.docx

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Manajemen Aktif Kala III :  Pemberian Oxytocin setelahbayilahir  Peregangan talipusat terkendali  Masase uterus setelah plasenta lahir  Perdarahan aktif  PenurunanTek. Darah  PeningkatanNadi

PERDARAHAN POST PARTUM Atonia Uterus TONUS

Resusitasi :  Infus 2 jalur  Oksigen sungkup  Monitor tanda vital  Balance cairan  Kerjasama Tim

Robekanjalanlahir Inversion uetri TRAUMA

Retensiopl asenta TISSUE

Gangguanpem bekuandrh TROMBIN

EMPAT T  Kompresi bimanual  Oxytocin 20 IU dlm RL/NaCl  InfusRL 500 L/10 mnt

 Eksploras ijalan lahir  Eksplorasi uterus

 Misoprostol/ cytotex 1000 mcg perrectal  Methergin 0,2 mg IV

 Jahit laserasi jalan lahir  Reposisi inversion uterus

 Observasi pembekuan darah  CekHb, Ht, CT, BT,gol.darah

Periksa kelengkapan plasenta

 Manual plasenta  Kuretase

 Penggantian factor pembekuan darah, tranfusi FFP  Tranfusi trombost

 Perdarahan> 1000-1500 ml  Perdarahan masif

 Tranfusi PRC, trombosit dan factor pembekuan darah  Peningkatan tekanan darah dengan pemberian vasopressor  Persiapan ICU untuk anestesi, hematologi & bedah  Prosedur tamponade uterus  Embolisasi pembuluh darah, ligasi, penjahitan, kompresi  Histerektomi

Paket pelatihan PONEK, Asuhan onstetri esensial, 2008

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