tag:blogger.com,1999:blog-33492802870258371192024-02-20T05:18:12.848-08:00dila ngeBlogAnonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.comBlogger18125tag:blogger.com,1999:blog-3349280287025837119.post-17994119041799402902013-01-11T00:08:00.001-08:002013-01-11T00:08:06.181-08:00Laporan Penimbangan Balita excel<!--[if gte mso 9]><xml>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Berikut adalah laporan penimbangan balita di puskesmas mulai dari bulanan, triwulan, semester dan tahunan. laporan
tahunan dengan menggunakan microsoft excel. untuk melihat hasilnya bisa dilihat<b> <a href="http://www.ziddu.com/download/21315566/TUGASEXCELAIDILLLA.xlsx.html" target="_blank">Here</a></b></span><a href="http://www.ziddu.com/download/21315566/TUGASEXCELAIDILLLA.xlsx.html" target="_blank"><b><span style="color: blue; font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"></span></b></a><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><br />
Langkah-langkah membuat file ini :</span></div>
<ol start="1" type="1">
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Buka file excel</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Untuk menulis judul, ketik judul di satu cell lalu klik
Format Cells atau CTRL 1 pilih alignment --> ubah text alignment
menjadi center --> klik wrap text --> OK</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Untuk menggabungkan 2 row sama dengan diatas lalu klik
merge cells --> OK</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Untuk membuat tabel CTRL 1 pilih borders lalu pilih
bentuk tabel --> OK</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Buat judul dengan rumus =judul&" Puskesmas
" &pusk&" "&kota&" Bulan
"&APR& " Tahun "&tahun -->enter</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Tambahkan komentar pada judul dengan cara klik kanan
pada judul lalu insert comment-->OK</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Membuat nomor urut yaitu ketik 2 nomor berurut ke bawah
--> blok --> tarik tanda tambah di pojok kanan bawah area yang
diblok</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Hitung K/S dengan cara mengklik di area tabel K dan S
rumus =D7/C7% -->enter</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Hitung D/S, N/D, N/S dengan cara yang sama dengan di
atas</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Untuk membuat kategori bina D/S, dicari dengan rumus
=IF(H7<TDSFEB,"BINA","-")-->enter</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Untuk kategori bina N/D dicari dengan rumus
=IF(I7<TNDJAN,"BINA","-")-->enter</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Untuk mengetahui hasil dibawahnya, tarik tanda tambah
di pojok kanan bawah area cells</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Mengisi catatan dengan rumus ="Catatan : Pada
bulan "&APR&" ini jumlah Posyandu yang perlu dibina D/S
adalah "&COUNTIF(K7:K16,"BINA")&" Posyandu dan
N/D "&COUNTIF(L7:L16,"BINA")&"
Posyandu"""-->enter</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Pada temapat dan tanggal, gunakan rumus
=""&Tempat&", 5 "&APR&"
"&tahun&"" Ingat : sebelumnya telah dibuat tabel
berisi bulan, nama dokter, NIP, TPG, dan NIP</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Masukkan nama pimpinan Puskesmas, pelapor, dan NIP
dengan rumus yang dibuat sesuai pada tabel yang dibuat pada poin 14 contoh
=PNAPRL</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Untuk membuat grafik klik insert-->chart-->select
data dari nama Posyandu-->OK</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Untuk mengunci sheet --> Home-->Format-->Protect
Sheet-->masukkan password-->OK</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Percantik lembaran excel dengan menambahkan Fill color
sesuai warna yang diinginkan</span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Tabulasikan data pada kolom D, N, dengan rumus
=AVERAGE(JAN!E7,FEB!E7,MAR!E7) enter lalu tarik tanda tambah pada pojok
kanan bawah ke bagian samping lalu ke bagian bawah </span></li>
<li class="MsoNormal" style="line-height: normal; mso-list: l0 level1 lfo1; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; tab-stops: list .5in;"><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Save data </span></li>
</ol>
<div class="MsoNormal">
Mudah Kan.....!!!!! :)</div>
<div class="MsoNormal">
<br /></div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com2tag:blogger.com,1999:blog-3349280287025837119.post-89596318367451060522013-01-10T20:50:00.000-08:002013-01-10T20:53:47.077-08:00Pre-Eklamsi hal 15<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Komplikasi Lain</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Lidah tergigit, trauma dan fraktur karena jatuh akibat
kejang – kejang pneumoni aspirasi dan <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314019/DIC.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">DIC</b></a>
(disseminated intravascular coagulation)</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">11) Pada Janin</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Menurut Rukiyah (2010), komplikasi pre eklamsia pada janin
adalah :</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Janin yang dikandung ibu hamil pre eklamsia akan hidup dalam
rahim dengan nutrisi dan oksigen dibawah normal. Keadaan ini bisa terjadi
karena pembuluh darh yang menyalurkan darah ke plasenta menyempit, karena
buruknya nutrisi pertumbuhan janin akan terhambat sehingga akan terjadi bayi
dengan berat lahir rendah. Bisa juga janin dilahirkan kurang bulan (prematuritas),
komplikasi lanjut dari prematuritas adalh keterlambatan belajar, epilepsy,
serebral palsy, dan masalah pada pendengaran dan penglihatan, bayi saat
dilahirkan asfiksia, dsb.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> DAFTAR PUSTAKA </span></b></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Adsence. 2012. <a href="http://www.jurnalskripsi.net/hubungan-paritas-dan-usia-ibu-dengan-kejadian-pre-eklampsia-berat-peb/2012/4873/"><span style="color: blue;">http://www.jurnalskripsi.net/hubungan-paritas-dan-usia-ibu-dengan-kejadian-pre-eklampsia-berat-peb/2012/4873/</span></a>
(Diakses tanggal 06 April 2012 )</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">2.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Angsar, 2008 <a href="http://www.google.com/"><span style="color: blue;">http://www.google.com</span></a>
(Diakses tanggal 06 April 2012)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Arikunto, Suharsini.2010. Prosedur
Penelitian Suatu Pendekatan Praktis. Jakarta:Rineka Cipta</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">4.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Bobak, Lowdermik, jansen. 2004. Buku
Ajar keperawatan Maternitas. Jakarta: EGC</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Boyle, Maureen. 2007. Buku Saku
Bidan Kedaruratan Dalam Persalinan. Jakarta: EGC</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Chapman, Vicky. 2006. Asuhan
Kebidanan Persalinan Dan Kelahiran. Jakarta: EGC</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Cuningham, F. Gary.Dkk. 2005.
Obstetri Williams. Jakarta : EGC</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Hidayat, Aziz Alimul. 2007. Riset
Keperawatan Dan Teknik Penulisan Ilmiah. Jakarta:Salemba Medika</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">9.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Manuaba, Candradinata.. 2008 . Gawat
Darurat Obstetri Ginekologi Dan Obstetri Ginekologi Social Untuk Profesi Bidan.
Jakarta : EGC</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">10.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Mitayani. 2009. Asuhan Keperawatan
Maternitas. Jakarta: Salemba Medika</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">11.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Mochtar, rustam. 2007. Sinopsis
Obstetri. Jakarta : EGC</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">12.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Notoatmodjo,Soekidjo. 2005.
Metodologi Penelitian Kesehatan. Jakarta:Rineka Cipta</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">13.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Nursalam. 2008. Konsep dan Penerapan
Metodologi Penelitian Ilmu keperawatan. Jakarta: Salemba Medika</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">14.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Rozikhan.2007. <a href="http://www.google.com/"><span style="color: blue;">http://www.google.com</span></a>
(Diakses tanggal 06 April 2012 )</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">15.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Sujiyatini, dkk. 2009. Asuhan
Patologi Kebidanan. Jakarta: Nuha Medika</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">16.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Suyanto dan Ummi Salamah. 2009.
Riset Kebidanan Metodologi Dan Aplikasi. Jogjakarta:Mitra Cendekia</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">17.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Woro, Dyah. 2012. <a href="http://alumni.unair.ac.id/detail.php?id=59119&faktas"><span style="color: blue;">http://alumni.unair.ac.id/detail.php?id=59119&faktas</span></a>
=Kedokteran (Diakses tanggal 03 April 2012 )</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">18.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Winkjosastro, Hanifa. 2006. Ilmu
Kebidanan. Jakarta: Yayasan Bina Pustaka</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">19.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Yeyeh, Rukiyah. 2010. Asuhan
Kebidanan 4 (Patologi). Jakarta: CV Trans Info Media</span><br />
<br />
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Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0tag:blogger.com,1999:blog-3349280287025837119.post-11812862452603870232013-01-10T20:49:00.001-08:002013-01-10T20:49:22.420-08:00Pre-eklamsi hal 14<div dir="ltr" style="text-align: left;" trbidi="on">
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<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 42.6pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.3pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">3) Mengakhiri
kehamilan sedapat dapatnya pada kehamilan 37 minggu ke atas apabila dirawat
tanda – tanda pre eklamsia tidak juga dapat hilang. (Rukiyah, 2010)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">12.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Komplikasi</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Komplikasi terberat adalah kematian ibu dan janin. <b style="mso-bidi-font-weight: normal;">Komplikasi</b> dibawah ini yang bisa
terjadi pada pre eklamsia dan eklamsia (Rukiyah, 2010) :</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">1) Solusio Plasenta</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Komplikasi ini terjadi pada ibu yang menderita hipertensi
akut dan lebih sering terjadi pada pre eklamsia</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">2) Hipofibrinogenemia</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Biasanya terjadi pada pre eklamsia berat. Oleh karena itu
dianjurkan untuk pemeriksaan kadar fibrinogen secara berkala.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">3) Hemolisis</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Penderita dengan PEB kadang – kadang menunjukkan gejala
klinik hemolisis yang dikenel dengan ikterus. Belum diketahui dengan pasti
apakah ini merupakan kerusakan sel hati atau destruksi sel darh merah. Nekrosis
periportal hati yang sering ditemukan pada autopsy penderita eklamsia dapat
menerangkan ikterus tersebut.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">4) <b><a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314218/perdarahanotakpdf.pdf.html" target="_blank">Perdarahan Otak</a></b></span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Komplikasi ini merupakan penyebab utama kematian maternal
penderita eklamsia.</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">5) Kelainan Mata</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Kehilangan penglihatan untuk sementara yang berlangsung
sampai seminggu dapat terjadi. Perdarahan kadang – kadang terjadi pada retina.
Hal ini merupakan tanda gawat akan terjadi apopleksia serebri.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">6) Edema Paru – Paru</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Paru – paru menunjukkan berbagai tingkat edema dan perubahan
karena bronkopnemonia sebagai akibat aspirasi. Kadang – kadang ditemukan abses
paru – paru.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">7) Nekrosis Hati</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Nekrosis periportal hati pada pre eklamsia/eklamsia
merupakan akibat <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314299/VASOSPASME.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">vasopasme</b></a> arteriole
umum. Kelainan ini diduga khas untuk eklamsia, tetapi juga dapat terjadi pada
penyakit lain. Kerusakan sel – sel hati dapat diketahui dengan pemeriksaan faal
hati, terutama penentuan enzim–enzimnya.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">8) Sindroma <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314054/helpsyndrom.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">HELLP</b></a> (Haemolisys elevated liver enzymes dan low palatelet)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Merupakan sindrom kumpulan gejala klinis berupa gangguan
fungsi hati, hepatoselular (peningkatan enzim hati [<b style="mso-bidi-font-weight: normal;">SGOT</b>,<b style="mso-bidi-font-weight: normal;">SGPT</b>], gejala
subyektif [cepat lelah, mual, muntah, nyeri epigastrium]). Hemolisis akibat
kerusakan membrane eritrosit oleh radiakl bebas asam lemak jenuh dan tak jenuh.
Trombositopenia (,150.000/cc), agregasi (adhesi trombosit did inding vaskuler),
kerusakan tromboksan (<a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314277/vasokontriktor.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">vasokonstriktor</b></a>
kuat), lisosom.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">9) Kelainan Ginjal</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Kelainan ini berupa endoteliosis glomerulus yaitu
pembengkakan sitoplasma sel endothelial tubulus ginjal tanpa kelainan struktur
yang lainnya. Kelainan lain yang dapat timbul ialah anuria samapi gagal ginjal.</span></div>
</div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0tag:blogger.com,1999:blog-3349280287025837119.post-39615288039052709592013-01-10T20:46:00.000-08:002013-01-10T20:46:02.407-08:00Pre-Eklamsia hal 13<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">) Perawatan aktif,
sedapat mungkin sebelum perawatan aktif pada setiap penderita dilakukan
pemeriksaan fetal assessment yakni pemeriksaan <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314165/nst.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">non stress test</b></a> (NST) dan ultrasonografi (USG) dengan indikasi
salah satu atau lebih yakni :</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -20.7pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">a) Ibu: Usia
kehamilan 37 minggu atau lebih, adanya tanda – tanda impending eklamsia,
kegagalan terapi konserfatif yaitu setelah 6 jam pengobatan meditasi terjadi
kenaikan desakan tekanan darah atau setelah 24 jam perawatan medicinal, ada
gejala – gejala status quo (tidak ada perbaikan)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -20.7pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">b) Janin: Hasil
fetal assasemen jelek (NST dan USG) adanya tanda <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314055/IUGR.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">IUGR</b></a></span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">c) Hasil
laboratorium: Adanya HELLP syndrome</span></div>
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<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 1.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -1.0cm;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">2) Pengobatan
medisinal pasien PEB dilakukan di RS dan atas instruksi dokter yaitu segera
masuk RS, tirah baring miring ke satu sisi. Tanda vital diperiksa setiap 30
menit, reflek patela setiap jam, infus dextrose 5% dimana setiap 1 liter
diselingi dengan infus RL (60 – 125 cc/jam) 500cc berikan antasida : diet cukup
protein, rendah karbohidrat lemak dan garam, pemberian obat anti kejang MgSO4
diuretikum tidak diberikan kecuali bila ada tanda – tanda edema paru, payah
jantungkongestif atau edema anasarka. Diberikan furosemid injeksi 40 mg/IM.</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">3) Antihapertensi
diberikan bila tekanan darah sistolis lebih 180 mmHg (diastol lebih 110 mmHg
atau MAP lebih 125 mmHg sasaran pengobatan adalah tekanan diastolis kurang 105
mmHg bukan kurang 90 mmHg karena akan menurunkan perfusi plasenta dosis
antihipertensi sama dengan dosis <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314022/antihipertensi.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">antihipertensi</b></a>
pada umumnya.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 1.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -1.0cm;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">4) Bila dibutuhkan
penurunan tekanan darah secepatnya diberikan obat–obat antihipertensi
parenteral (tetesan kontinyu) <b style="mso-bidi-font-weight: normal;">catapres</b>
<b style="mso-bidi-font-weight: normal;">injeksi</b>. Dosis yang biasa dipakai 5
ampul dalam 500 cc cairan infus atau pres disesuaikan dengan tekanan darah.</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">5) Bila tidak
tersedia antihipertensi parenteral dapat di berikan tablet anti hipertensi
secara sublingual diulang selang 1 jam maksimal 4 – 5 kali. Bersama dengan awal
pemberian sublingual maka obat yang sama mulai diberikan secara oral.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 1.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -1.0cm;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">6) Pengobatan
jantung jika ada indikasinya yakni ada tanda – tanda menjurus payah jantung
diberikan digitalisasi cepat dengan cedilanid D.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 1.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -1.0cm;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">7) Lain – lain :
Konsul penyakit dalam/jantung, mata, obat – obat anti piretik diberikan bila
suhu rectal 38,5ºC dapat dibantu dengan pemberian kompres dingin atau alkohol
atau xylomidon 2 cc IM, <b style="mso-bidi-font-weight: normal;">antibiotik</b>
diberikan atas indikasi. Diberikan ampicilin 1 gr/ 6 jam/ IV/hari, anti nyeri
bila penderita kesakitan atau gelisah karena kontraksi uterus dapat diberikan
petidin HCL 50 – 75 mg sekali saja, selambat lambatnya 2 jam sebelum janin
lahir.</span></div>
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<br /></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">11.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Pencegahan</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Pada umumnya timbulnya eklamsia
dapat dicegah atau frekuensinya dapat dikurangi. Usaha – usaha untuk menurunkan
frekuensi eklamsia adalah :</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">1) Meningkatkan
jumlah balai pemeriksaan antenatal dan mengusahakan agar semua wanita hamil
memeriksakan diri sejak hamil muda.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 42.6pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.3pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">2) Mencari pada
tiap pemeriksaan tanda-tanda pre eklamsia dan megobatinya segera bila ditemukan</span></div>
</div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0tag:blogger.com,1999:blog-3349280287025837119.post-38382631964487047182013-01-10T20:44:00.000-08:002013-01-10T20:44:04.760-08:00Pre-Eklamsi hal 12<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Riwayat kesehatan sekarang</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">a) Ibu merasakan sakit kepala di daerah
frontal</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">b) Terasa sakit di ulu hati/nyeri <b style="mso-bidi-font-weight: normal;">epigastrium</b></span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">c) Gangguan virus : pandangan mata kabur,
skotoma dan diplopia</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">e) Gangguan serebral lain misal: refleks tinggi
dan tidak tenang</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">f) Edema pada ekstremitas</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">g) Tengkuk terasa berat</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">h) Kenaikan berat badan mencapai 1 kg seminggu</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Penanganan Preeklamsia ringan
menurut Rukiyah (2010), dapat dilakukan dengan dua cara tergantung gejala yang
timbul yakni :</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">1. Pre Eklamsia Ringan</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">a) Penatalaksanaan
rawat jalan pasien preeklamsia ringan, dengan cara : ibu dianjurkan banyak
istirahat (berbaring,tidur/miring), diet : cukup protein, rendah <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314092/karbohidratpdf.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">karbohidrat</b></a>, lemak dan garam; pemberian
<b style="mso-bidi-font-weight: normal;">sedativa</b> ringan : tablet phenobarbital
3×30 mg atau diazepam 3×2 mg/oral selama 7 hari (atas instruksi dokter);
roborantia; kunjungan ulang selama 1 minggu; pemeriksaan laboratorium: <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314056/Haemoglobin_Aug_2008.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">hemoglobin</b></a>, hematokrit, trombosit, urin
lengkap, asam urat darah, fungsi hati, fungsi ginjal.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -20.7pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">b) Penatalaksanaan
rawat tinggal pasien preeklamsi ringan berdasarkan kriteria : setelah duan
minggu pengobatan rawat jalan tidak menunjukkan adanya perbaikan dari
gejala-gejala preeklamsia; kenaikan berat badan ibu 1kg atau lebih/minggu
selama 2 kali berturut-turut (2 minggu); timbul salah satu atau lebih gejala
atau tanda-tanda preeklamsia berat.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> Bila setelah satu minggu
perawatan diatas tidak ada perbaikan maka preeklamsia ringan dianggap sebagai
preeklamsia berat. Jika dalam perawatan dirumah sakit sudah ada perbaikan
sebelum 1 minggu dan kehamilan masih preterm maka penderita tetap dirawat
selama 2 hari lagi baru dipulangkan. Perawatan lalu disesuaikan dengan
perawatan rawat jalan.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Perawatan obstetri pasien
preeklamsia menurut Rukiyah (2010) adalah :</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">a) Kehamilan <b style="mso-bidi-font-weight: normal;">preterm</b> (kurang 37 minggu) : bila
desakan darah mencapai normotensi selama perawatan, persalinan ditunggu sampai
aterm; bila desakan darah turun tetapi belum mencapai normotensi selama
perawtan maka kehamilanya dapat diakhiri pada umur kehamilan 37 minggu atau
lebih.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">b) Kehamilan aterm
(37 minggu atau lebih) : persalinan ditunggu sampai terjadi onset persalinan
atau dipertimbangkan untuk melakukan persalinan pada tanggal taksiran
persalinan</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">c) Cara
persalinan: Persalinan dapat dilakukan secara spontan bila perlu memperpendek
kala II.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">2.Pre eklamsia Berat</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Ditinjau dari umur kehamilan dan
perkembangan gejala-gejala preeklamsia berat selama perawatan maka perawatan
dibagi menjadi : 1). Perawatan aktif yaitu kehamilan segera diakhiri atau
diterminasi ditambah pengobatan medicinal; 2) Perawatan konservatif yaitu
kehamilan tetap dipertahankan ditambah pengobatan medicinal.</span></div>
</div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0tag:blogger.com,1999:blog-3349280287025837119.post-52733691365329124092013-01-10T20:41:00.001-08:002013-01-10T20:41:34.091-08:00Pre-Eklamsia Hal 11<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">plasma menurun pada pre eklampsia, kecuali pada penyakit
yang berat dengan hemokonsentrasi. Pada kehamilan cukup bulan kadar <b style="mso-bidi-font-weight: normal;">fibrinogen</b> meningkat dengan nyata.
Kadar tersebut lebih meningkat lagi pada pre eklampsia. Waktu pembekuan lebih
pendek dan kadang-kadang ditemukan kurang dari 1 menit pada eklampsia. </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">7.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Frekuensi</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Ada yang melaporkan angka kejadian
sebanyak 6% dari seluruh kehamilan, dan 12% pada kehamilan primigravida.
Menurut beberapa penulis lain frekuensi dilaporkan sekitar 3-10%. Lebih banyak
dijumpai pada primigravida daripada multigravida, terutama primigravida usia
muda. Faktor-faktor predisposisi untuk terjadinya preeklamsia adalah
molahidatidosa, diabetes melitus, kehamilan ganda, hidrops fetalis, obesitas,
dan umur yang lebih dari 35 tahun (Mochtar, 2007).</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Menurut Winkjosastro Hanifa (2006)
Frekuensi pre eklamsia pada tiap negara berbeda-beda karena banyak faktor yang
mempengaruhinya; jumlah primigravida, keadaan sosial ekonomi, perbedaan
kriterium dalam penentuan diagnosis, dan lain-lain. Dalam kepustakaan frekuensi
dilaporkan berkisar antara 3-10%. Pada primigravida frekuensi pre eklamsia
lebih tinggi bila dibandingkan dengan multi gravida, hidrops fetalis, umur >
35 tahun, dan <b style="mso-bidi-font-weight: normal;">obesitas</b> merupakan
faktor <b style="mso-bidi-font-weight: normal;">predisposisi</b> untuk terjadinya
pre eklamsia. </span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo2; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">8.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Faktor resiko pre eklamsia</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Menurut Chapman Vicky (2006), factor resiko pre eklamsia :</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">1) Pre eklamsia 10 kali lebih sering
terjadi pada primigravida</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">2) Kehamialn ganda memiliki resiko lebih
dari 2 kali lipat</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">3) Obesitas (yang dengan indeks masa tubuh
> 29) meningkatkan resiko 4 kali lipat.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">4) Riwayat hipertensi</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">5) Diabetes</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">6) Pre eklamsia sebelumnya (20% resiko
kekambuhan)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> Menurut Bobak (2004), factor resiko pre eklamsia :</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">1) <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314217/pimigravida.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">Primigravid</b></a>, multi para (Mitayani, 2009)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">2) Usia < 20 atau > 35 tahun</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">3) <b style="mso-bidi-font-weight: normal;">Obesitas</b></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">4) <b><a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314020/diabetesmelitus.pdf.html" target="_blank"> Diabetesmilitus</a></b></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">5) Hipertensi sebelumnya</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">6) Kehamilan mola</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">7) Kehamilan ganda</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">8) <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314216/polyhidromnions.pdf.html" target="_blank"> <b style="mso-bidi-font-weight: normal;">Polihidramnion</b></a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">9) Pre eklamsia pada kehamilan
sebelumnya </span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">9.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Diagnosis</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Menurut Mitayani (2009), diagnosis
di tegakkan berdasarkan :</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">1. Wawancara</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">a. Riwayat Kesehatan</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">1) Riwayat
kesehatan dahulu</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">a) Kemungkinan ibu menderita penyakit hipertensi
sebelum hamil</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">b) Kemungkinan ibu mempunyai riwayat pre eklamsia
pada kehamilan terdahulu</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">c) Biasanya mudah terjadi pada ibu yang obesitas</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">d) Ibu mungkin pernah menderita ginjal kronis</span></div>
</div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0tag:blogger.com,1999:blog-3349280287025837119.post-56466735771396340442013-01-10T20:38:00.003-08:002013-01-10T20:38:47.659-08:00Pre-Eklamsi hal 10<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Kematian ibu pada pre-eklamsia dan eklamsia biasanya
disebabkan oleh edema paru yang menimbulkan decompensasi cordis. Bisa pula
karena terjadinja aspirasi pnemonia,atau abses paru.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">e.Perubahan pada otak</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Mc Call melaporkan bahwa resistensi pembuluh darah dalam
otak pada hipertensi dalam kehamilan lebih meninggi lagi pada eklampsia.
Walaupun demikian, aliran darah ke otak dan pemakaian oksigen pada pre
eklampsia tetap dalam batas normal. Pemakaian oksigen oleh otak hanya menurun
pada eklampsia.</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> f. Metabolisme air dan Elektrolit</span></div>
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">Hemokonsentrasi yang menyertai pre eklampsia dan
eklampsia tidak hanya diketahui sebabnya. Terjadi disini pergeseran cairan dari
ruang intravaskuler ke ruang interstisial. Kejadian ini, yang diikuti oleh
kenaikan hematokrit, peningkatan protein serum dan sering bertambah edema,
menyebabkan volume darah mengurang, <b style="mso-bidi-font-weight: normal;">viskositet</b>
darah meningkat, waktu peredaran darah tepi lebih lama. Karena itu, aliran
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Dengan perbaikan keadaan, hemokonsentrasi berkurang, sehingga turunnya
hematokrit dapat dipakai sebagai ukuran tentang perbaikan keadaan penyakit dan tentang
berhasilnya pengobatan. Jumlah air dan natrium dalam badan lebih banyak pada
penderita pre eklampsia daripada wanita hail biasa atau penderita hipertensi
menahun. Penderita pre eklampsia tidak dapat mengeluarkan dengan sempurna air
dan garam yang diberikan. Hal ini disebabkan oleh filtrasi glomerulus menurun,
sedangkan penyerapan kembali tubulus tidak berubah. Elektrolid, <b style="mso-bidi-font-weight: normal;">kristaloid</b> dan protein dalam serum
tidak menunjukkan perubahan yang nyata pada pre eklampsia. Konsentrasi kalium,
natrium, kalsium dan klorida dalam serum biasanya dalam batas normal. Gula
darah, ikarbonas dan pH pun normal. Pada eklampsia, kejang-kejang dapat
menyebabkan kadar gula darah naik untuk sementara; asidum laktikum dan asam
organic lain naik dan bikarbonas natrikus, sehingga menyebabkan cadangan alkali
turun. Setelah kejangan, zat organic dioksida sehingga natrium dilepaskan untuk
dapat bereaksi dengan asam karbonik menjadi bikarbonas natrikus. Dengan
demikian cadangan alkali dapat pulih kembali. Oleh beberapa penulis kadar asam
urat dalam darah dipakai sebagai parameter untuk menentukan proses pre
eklampsia menjadi baik atau tidak. Pada keadaan normal asam urat melewati <b style="mso-bidi-font-weight: normal;">glemorulus</b> dengan sempurna untuk
diserap kembali dengan sempurna oleh tubulus kontorti proksimalis dan akhirnya
dikeluarkan oleh tubulus kontorti distalis. Tampaknya perubahan pada glomerulus
dengan sempurna untuk diserap kembali dengan sempurna oleh tubulus kontorti
proksimalis dan akhirnya dikeluarkan oleh tubulus kontorti distalis. Tampaknya
perubahan pada glomerulus menyebabkan filtrasi asam urat mengurang, sehingga
kadarnya dalam darah meningkat. Akan tetapi, kadar asam urat yang tinggi tidak
selalu ditemukan. Selanjutnya, pemakaian diuretika golongan tiazid menyebabkan
kadar asam urat meningkat. Kadar keratin dan ureum pada pre eklampsia tidak
meningkat, kecuali bila terjadi oliguria atau anuria. Protein serumtotal,
perbandingan albumin globulin dan <b style="mso-bidi-font-weight: normal;">tekanan</b>
<b style="mso-bidi-font-weight: normal;">osmotic</b> </span></div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0tag:blogger.com,1999:blog-3349280287025837119.post-31514746261123091052013-01-10T20:37:00.005-08:002013-01-10T20:37:58.013-08:00Pre-Eklamsi Hal 9<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">(1958) menggambarkan pendarahan subendokardial disebelah
kiri septum interventrikulare pada kira-kira dua pertiga penderita eklampsia
yang meninggal dalam 2 hari pertama setelah timbulnya penyakit.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> h.Kelenjar adrenal</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Kelenjar adrenal dapat menunjukkan kelainan berupa
pendarahan dan nekrosis dalam berbagai tingkat.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">2) Perubahan
fisiologi patologik</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">a.Perubahan pada plasenta dan uterus</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Menurunnya aliran darh ke plasenta mengakibatkan disfungsi
plasenta. Pada hipertensi yang agak lama pertumbuhan janin terganggu, pada
hipertensi yang lebih pendek bisa terjadi gawat janin sampai kematiannya karena
kekurangan oksigenasi. Kenaikan <b style="mso-bidi-font-weight: normal;">tonus
uterus</b> dan kepekaan terhadap perangsangan sering didapatkan pada pre
eklamsia dan eklamsia sehingga mudah terjadi partus prematurus.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> b.Perubahan pada ginjal</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Perubahan pada ginjal disebabkan oleh aliran darah ke dalam
ginjal menurun, sehingga menyebabkan filtrasi glomerulus mengurang. Kelainan
pada ginjal yang penting ialah dalam hubungan dengan proteinuria dan mungkin
sekali juga dengan retensi air garam dan air. Mekanisme retensi garam dan air
belum diketahui benar, tetapi disangka akibat perubahan dalam perbandingan
antara tingkat filtrasi glomerulus dan tingkat penyerapan kembali oleh tubulus.
Pada kehamila normal penyerapan ini meningkat sesuai dengan kenaikan filtrasi
glomerulus. Penurunan filtrasi glomerulus akibat spasmus arterioles ginjal
menyebabkan fltrasi natrium melalui glomerulus menurun, yang menyebabkan
retensi garm dan dengan demikian juga retensi air. Peranan kelenjar adrenal
dalam retensi garam dan air belum diketahui benar. Fungsi ginjal pada pre
eklampsia tampaknya agak menurun bila dilihat dari clearance asam uric.
Filtrasi glomerulus dapat turun sampai 50% dari normal, sehingga menyebabkan
dieresis turun; pada keadaan lanjut dapat terjadi oliguria atau anuria.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> c.Perubahan pada retina</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Pada pre eklampsia tampak edema retina, spasmus setempat
atau enyeluruh pada satu atau beberapa arteri; jarang terlihat perdarahan atau
eksudat. Retinopatia arteriosklerotika menunjukkan penyakit vaskuler yang
menahun. Keadaan tersebut tak tampak pada pre eklampsia, kecuali bila terjadi
atas dasar hipertensi menahun atau penyakit ginjal. Spasmus arteri retina yang
nyata menunjukkan adanya pre eklampsia berat; walaupun demikian, vasopasmus
ringan tidak selalu menunjukkan pre eklampsia ringan. Pada pre eklampsia jarang
terjadi ablasio retina. Keadaan ini disertai dengan buta sekonyong-konyong.
Pelepasan retina disebabkan oleh <b style="mso-bidi-font-weight: normal;">edema</b>
<b style="mso-bidi-font-weight: normal;">intraokuler</b> dan merupakan indikasi
untuk pengakhiran kehamilan segera. Biasanya setelah persalinan berakhir.
Retina melekat lagi dalam 2 hari sampai 2 bulan. Gangguan penglihatan secara
tetap jarang ditemukan. Skotoma, diplopia dan ambliopia pada penderita pre
eklampsia merupakan gejala yang menunjukkan akan terjadinya eklampsia. Keadaan
ini disebabkan oleh perubahan aliran darah dalam pusat penglihatan di <b style="mso-bidi-font-weight: normal;">korteks</b> <b style="mso-bidi-font-weight: normal;">serebri</b> atau dalam retina.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> d.Perubahan pada Paru – paru</span></div>
</div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0tag:blogger.com,1999:blog-3349280287025837119.post-28778629720022611122013-01-10T20:37:00.000-08:002013-01-10T20:37:05.983-08:00Pre-Eklamsia Hal 8<div dir="ltr" style="text-align: left;" trbidi="on">
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ginjal dan pada pemotongan mungkin ditemukan perdarahan – perdarahan kecil.
Penyelidikan biopsi pada ginjal oleh Altchek dan kawan-kawan (1968) menunjukkan
pada pre eklamsia bahwa kelainan berupa: 1) kelainan glomerulus; 2) hiperplasia
sel-sel jukstaglomerulus; 3) kelainan pada tubulus-tubulus henle; 4) spasme
pembuluh darah ke <b style="mso-bidi-font-weight: normal;">glomerulus</b>.
Glomerulus tampak sedikit membengkak dengan perubahan-perubahan sebagai
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biasa bahwa membrana basalis dinding kapiler glomerulus seolah-olah terbelah,
tetapi ternyata keadaan tersebut dengan mikroskop elektron disebabkan oleh
bertambahnya matriks mesangial; c) sel-sel kapiler membengkak dan lumen
menyempit atau tidak ada; d) penimbunan zat protein berupa serabut ditemukan
dalam kapsul bowman. Sel-sel jukstaglomeruler tampak membesar dan bertambah
dengan pembengkakan sitoplasma sel dan bervakuolisasi. <b style="mso-bidi-font-weight: normal;">Epitel</b> tubulus-tubulus henle ber<b style="mso-bidi-font-weight: normal;">deskuamasi</b> hebat, tampak jelas fragmen inti sel terpecah-pecah.
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regenerasi. Perubahan – perubahan tersebutlah tampaknya yang menyebabkan <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314219/Proteinuria.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">proteinuria</b> </a>dan mungkin sekali ada
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Alat ini besarnya normal, pada permukaan dan pembelahan
tampak tempat – tempat perdarahan yang tidak teratur. Pada pemerikaan
mikroskopik dapat ditemukan pedarahan dan nekrosis pada tepi lobules, disertai
thrombosis pada pembuluh darah kecil, terutama disekitar vena porta. Walaupun
umumnya lokasi ialah <b style="mso-bidi-font-weight: normal;">periportal</b>,
namun perubahan tersebut dapat ditemukan ditemukan ditempat-tempat lain. Dalam
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perubahan hati.</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Pada penyakit yang belum lanjut hanya ditemukan edema dan
anemia pada korteks serebri, pada keadaan lanjut ditemukan perdarahan.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">e. Retina</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Kelainan yang sering ditemukan pada retina ialah spasmus
pada arteriola – arteriola, terutama yang dekat pada diskus optikus. Vena
tampak lekuk pada persimpanagan dengan arteriola. Dapat terlihat edema pada
diskus optikus dan retina. <b style="mso-bidi-font-weight: normal;">Ablasio
retina</b> juga dapat terjadi tetapi komplikasi ini prognosisnya baik karena
retina akan melekat lagi beberapa minggu post partum. Perdarahan dan eksudat
jarang ditemukan pada pre eklamsia, biasanya kelainan tersebut menunjukkan
adanya hipertensi menahun.</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">f.Paru-Paru</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Paru-paru menunjukkan berbagai tingkat edemma dan perubahan
karena <b style="mso-bidi-font-weight: normal;">bronkopnemonia</b> sebagai akibat
aspirasi. Kadang – kadang ditemukan abses paru – paru.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> g.Jantung</span></div>
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">Pada sebagian besar penderita yang mati
karena eklamsi jantung biasanya mengalami perubahan degeneratif pada <b style="mso-bidi-font-weight: normal;">miokardium</b>. Sering ditemukan degenerasi
lemak dan cloudy swelling serta nekrosis dan pendarahan. Sheehan </span></div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0tag:blogger.com,1999:blog-3349280287025837119.post-70913218480553282672013-01-10T20:34:00.000-08:002013-01-10T20:34:27.779-08:00Pre-Eklamsia Hal 7<div dir="ltr" style="text-align: left;" trbidi="on">
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<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">c) Pemeriksaan kuatitatif bisa disertai
dengan :</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">d) Oliguria, yaitu jumlah urin kurang dari
500 cc per 24 jam.</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">e) Adanya gangguan serebral, gangguan
visus, dan rasa nyeri di epigastrium.</span></div>
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<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">g) Gangguan perkembangan intra uterin</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
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<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">5.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Gejala pre eklamsia</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Biasanya gejala pre eklmsia timbul
dalam urutan : pertambahan berat badan yang lebih, diikuti edema, hipertensi,
dan akhirnya protein urin. Pada pre eklamsia ringan tidak di temui gejala –
gejala subyektif, namun menurut rukiyah (2010) mengatakan :</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">1) Pre eklamsia
Ringan</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -20.7pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">a) Kenaikan
tekanan darh sistol 30 mmHg atau lebih</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -20.7pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">b) Kenaikan
tekanan <b style="mso-bidi-font-weight: normal;">diastole15</b> mmHg atau lebih
dari tekanan darah sebelum hamil pada kehamilan 20 minggu atau lebih</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -20.7pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">c) Protein urin
secara kuantitatif lebih 0,3 gr/liter dalam 24 jam atau secara kualitatif
positif 2</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -20.7pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">d) Edema pada
pretebia, dinding abdomen, <b style="mso-bidi-font-weight: normal;">lumbosakral</b>,
dan wajah</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">2) Pre eklamsia
Berat</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">a) Tekanan darah sistolik ≥ 160 mmHg</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">b) Tekanan darah diastolik ≥ 110 mmHg</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">c) Peningkatan kadar enzim hati/ikterus</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">d) Trombosit < 100.000/mm3</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">e) Oligouria < 400 ml/24 jam</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">f) Protein urin > 3 gr/liter</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">g) Nyeri epigastrium</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">h) Skotoma dan gangguan visus lain atau nyeri
frontal yang berat</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">i) <b style="mso-bidi-font-weight: normal;">Perdarahan retina</b></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">j) Edema pulmonum</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 18.0pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo2; tab-stops: list 18.0pt; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">6.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Perubahan Pada Organ-Organ</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Menurut Winkjasastro Hanifa (2006)
pada penderita preeklamasi dapat terjadi perubahan pada organ-organ, antara
lain :</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">1) Perubahan
anatomi patologik</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">a.Plasenta</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Pada pre eklamsia terdapat spasme arteriol spiralis desidua
dengan akibat menurunnya aliran darah ke plasenta. Perubahan plasenta normal
sebagai akibat tuanya kehamilan, seperti menipisnya sinsitium, menebalnya
dinding pembuluh darah dalam vili karena <b style="mso-bidi-font-weight: normal;">fibrosis</b>
dan konversi mesoderm menjadi jaringan fibrotik dipercepat prosesnya pada pre
eklamsia dan hipertensi. Pada pre eklamsia yang jelas ialah atrofi sinsitium,
sedangkan pada hipertensi menahun terdapat terutama perubahan pada pembuluh
darah dan stroma. Arteri spiralis mengalami <b style="mso-bidi-font-weight: normal;">konstriksi</b> dan penyempitan, akibat aterosis akut disertai
necrotizing arteriopathi.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">b.Ginjal</span></div>
</div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0tag:blogger.com,1999:blog-3349280287025837119.post-36879062290783657742013-01-10T20:33:00.000-08:002013-01-10T20:33:14.384-08:00Pre-Eklamsia hal 6<div dir="ltr" style="text-align: left;" trbidi="on">
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<br />
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">meningkatkan volume sekuncup jantung
dan tekanan darah dapat dipertahankan. Kalsium pada otot pembuluh darah
mengendalikan dan mengurangi kontraksi-kontraksi sehingga tekanan darah dapat
dikendalikan bersama dengan vasokontriktor lainnya. Kekurangan kalsium yang
terlalu lama menyebabkan dikeluarkannya kalsium dari jaringan otot sehingga
menimbulkan manifestasi sebagai berikut : keluar dari otot jantung menimbulkan
melemahnya kontraksi otot jantung dan menurunkan volume sekuncup sehingga
aliran darah akan menurun; keluar dari otot pembuluh darah akan menimbulkan kontraksi,
meningkatkan <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314089/jurnal-hipertensi-terhadap-rokok.pdf.html%20%20%20%20%09Send%20the%20Document%20File%28s%29%20Link%20to%20your%20Friends%20Your%20Name:%20%09%20Your%20Email:%20%09%20Your%20friends%20email%20ID:%20%09%20%09%20Only%201%20Email%20Allowed%20at%20a%20time.%20Secuirty%20Code:%20%09%20%09%20%09%20%09" target="_blank"><b style="mso-bidi-font-weight: normal;">tekanan darah tinggi</b>.</a></span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Dengan demikian ibu hamil memerlukan
2 – 2,5 g kalsium untuk mempertahankan konsentrasi dalam darah menjadi konstan,
sehingga tidak akan menimbulkan peningkatan tekanan darah. Dalam praktik
sehari-hari, bidan sudah dapat memberi kalsium pada ibu hamil yang merupakan
otot polos dapat digambarkan sebagai berikut :</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">1) Ikatan antara
myosin dan aktin menjadi dasar terjadinya kontraksi dengan peranan kalsium.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">2) Bila terjadi
penurunan konsentrasi kalsium akan terjadi reaksi yang berlawanan sehingga
kontraksi meurun dan akibat terdapat penurunan volume sekuncup jantung dan
seterusnya mengakibatkan <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314053/iskemik.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">iskemia region</b>.</a>
Penurunan kalsium dapat terjadi karena masukan yang kurang, kemampuan
resorbi menurun kalsium mengalami keterasingan (terisolasi)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Hal ini menyebabkan mata rantai
peranan terputus. Pemberian kalsium 22,5 g pada ibu hamil akan menurunkan
kejadian pre eklampsia / eklampsia yang bermakna terutama melalui kerja pada
miosis kinase rantai ringan. Dalam standar pendidikan obstetric dan ginekologi,
POGI tersurat teori yang dianut “iskemia region uteroplasenter” dengan teori
lainnya. Kejadian pre eklampsia/ eklampsia yaitu antara <b style="mso-bidi-font-weight: normal;">antepartus</b>, <b style="mso-bidi-font-weight: normal;">intrapartus</b>
dan <b style="mso-bidi-font-weight: normal;">pasca partus</b>.</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> Klasifikasi</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">1) Pre-eklamsia
ringan</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Adalah timbulnya hipertensi disertai protein urin dan atau
edema setelah umur kehamilan 20 minggu atau segera setelah kehamilan. Gejala
ini dapat timbul sebelum umur kehamilan 20 minggu pada penyakit <b style="mso-bidi-font-weight: normal;">trofoblas</b> (Rukiyah, 2010). Gejala
klinis pre eklamsi ringan meliputi :</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.25pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">a) Kenaikan
tekanan darah sistol 30 mmHg atau lebih, diastol 15 mmHg atau lebih dari
tekanan darah sebelum hamil pada kehamilan 20 minggu atau lebih atau sistol 140
mmHg sampai kurang 160 mmHg, diastol 90 mmHg sampai kurang 110 mmHg.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.25pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">b) Edema pada
pretibia, dinding abdomen, lumbosakral, wajah atau tangan</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.25pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">c) Proteinuria
secara kuantitatif lebih 0,3 gr/liter dalam 24 jam atau secara kualitatif
positif 2.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 2.0cm; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.25pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">d) Tidak disertai
gangguan fungsi organ</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> 2)
Pre-eklamsia berat</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Adalah suatu komplikasi kehamilan yang di tandai dengan
timbulnya hipertensi 160/110 mmHg atu lebih disertai protein urin dan atau
edema pada kehamilan 20 minggu atau lebih (Rukiyah, 2010).</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Gejala dan tanda pre eklamsia berat :</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">a) Tekanan darah sistolik >160 dan
diastolik >110 mmHg atau lebih.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">b) Proteinuria > 3gr/liter/24 jam atau
positif 3 atau positif 4</span></div>
</div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0tag:blogger.com,1999:blog-3349280287025837119.post-53068720812712396382013-01-10T20:29:00.000-08:002013-01-10T20:29:04.731-08:00Pre-Eklamsia hal 5<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">kenaikan tekanan perifer agar
oksigenasi jaringan dapat dicukupi. Sedangkan kenaikan berat badan dan edema
yang disebabkan oleh penimbunan air yang berlebihan dalam ruangan intertisial
belum diketahui penyebabnya, mungkin karena retensi air dan garam. Proteinuria
dapat disebabkan oleh <b style="mso-bidi-font-weight: normal;">spasme arteriola</b>
sehingga terjadi perubahan glomerolus.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> Menurut Rukiyah (2010)
Vaskonstriksi merupakan dasar patogenesis PE-E. Vasokonstriksi menimbulkan
peningkatan total perifer resisten dan menimbulkan hipertensi . adanya
vasokonstriksi juga akan menimbulkan hipoksia pada endotel setempat, sehingga
terjadi kerusakan endotel setempat, sehingga terjadi kerusakan endotel,
kebocoran arteriol disertai perdarahan mikro pada tempat endotel. Selain itu
Hubel 1989 yang dikutip oleh Rukiyah (2010) mengatakan bahwa adanya
vasokonstriksi arteri spiralis akan menyebabkan terjadinya penurunan perfusi
utero plasenta yang selanjutnya akan menimbulkan maladaptasi plasenta.
Hipoksi/anoksia jaringan merupakan sumber reaksi hiperoksidase lemak, sedangkan
prose hiperoksidase itu sendiri memerlukan peningkatan konsumsi oksigen,
sehingga dengan demikian akan menggangu metabolisme di dalam sel peroksidase
lemak adalah hasil proses oksidase lemak tak jenuh yang menghasilkan <b style="mso-bidi-font-weight: normal;">hiperoksidase</b> lemak jenuh. Peroksidase
lemak merupakan radikal bebas. Apabila keseimbangan antara peroksidase
terganggu diman peroksidase dan oksidan lebih dominan maka akan timbul keadaan
yang disebut stress oksidatif. Pada PE-E serum anti oksidan kadarnya menurun
dan plasenta menjadi sumber terjadinya peroksidase lemak. Sedangkan pada wanita
hamil normal serumnya mengandung transferin, ion tembaga dan sulfhidril yang
berperan sebagai antioksidan yang cukup kuat. Peroksidase lemak beredar dalam
aliran darh melalui ikatan lipoprotein. Peroksidase lemak ini akan sampai kesemua
komponen sel yang dilewati termasuk sel-sel endotel tersebut. Rusaknya sel-sel
endotel tersebut. Rusaknya sel – sel endotel akan mengakibatkan antara lain:
adhesi dan agresi trombosit, gangguan permeabilitas lapisan endotel terhadap
plasma, terlepasnya enzim lisosom, tromboksan dan serotinin sebagai akibat
rusaknya trombosit, produksi prostasiklin dan tromboksan, terjadi <b style="mso-bidi-font-weight: normal;">hipoksia plasenta</b> akibat konsumsi
oksigen oleh peroksidase lemak.</span></div>
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"> Menurut Zweifel (1922) yang dikutip oleh
Manuaba (2008) mengemukakan bahwa gejala gestosis tidak dapat diterangkan
dengan satu faktor atau teori tetapi merupakan multifakor (teori yang
menggambarkan berbagai manifestasi klinis yang kompleks yang oleh Zweifel
disebut diseases of theory. Berbagai teori yang mencoba menerangkan gambaran
klinis adalah genetic, teori imunologik, teori iskemia region uteroplasenter,
teori kerusakan endotel pembuluh darah, teori radikal bebas adan kerusakan
endotel, teori trombosit, dan teori diet yang diterangkan untuk kepentingan
sehari-hari adalah teori diet dan teori yang diakui POGI. Menurut teori <b style="mso-bidi-font-weight: normal;">diet ibu hamil</b>, kebutuhan kalsium ibu
hamil cukup tinggi untuk pembentukan tulang dan organ lain janin, yaitu 2-2,5
g/hari. Bila terjadi kekurangan kalsium, kalsium ibu hamil akan dikuras untuk memenuhi
kebutuhan sehingga terjadi pengeluaran kalsium dari jaringan otot. Minyak ikan
mengandung banyak asam lemak tak jenuh sehingga dapat menghindari dan
menghambat pembentukan trombokson dan mengurangi aktivitas trombosit. Oleh
karena itu, minyak ikan dapat menurunkan kejadian pre eklamasia / eklamasia.
Diduga bahwa minyak ikan mengandung kalsium. Fungsi kalsium dalam otot jantung
menimbulkan peningkatan kontraksi sehingga dapat mempertahankan dan </span></div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0tag:blogger.com,1999:blog-3349280287025837119.post-20039141523840981122013-01-10T20:27:00.001-08:002013-01-10T20:27:57.296-08:00pre-Eklamsi hal 4<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">pre eklamsia, 26% anak perempuannya akan mengalami pre
eklamsia pula, sedangkan hanya 8% anak menantu mengalami pre eklamsia.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> 6) Teori
Defisiensi Gizi</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Beberapa hasil penelitian menunjukkan bahwa <b style="mso-bidi-font-weight: normal;">defisiensi gizi</b> berperan dalam
terjadinya hipertensi dalam kehamilan. Penelitian terakhir membuktikan bahwa
konsumsi minyak ikan dapat mengurangi resiko pre eklamsia. Minyak ikan banyak
mengandung asam lemak tidak jenuh yang dapat menghambat produksi tromboksan,
menghambat aktivasi trombosit, dan mencegah <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314277/vasokontriktor.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">vasokonstriksi</b></a> pembuluh darah.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">7) Teori Stimulasi
Inflamasi</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Teori ini berdasarkan bahwa lepasnya debris trofoblas di
dalam sirkulasi darah merupakan rangsangan utama terjadinya proses <b style="mso-bidi-font-weight: normal;">inflamasi</b>. Berbeda dengan proses
apoptosis pada pre eklamsia, dimana pada pre eklamsia terjadi peningkatan stres
oksidatif sehingga produksi debris trofoblas dan nekrorik trofoblas juga
meningkat. Keadaan ini mengakibatkan respon inflamasi yang besar juga. Respon
inflamasi akan mengaktifasi sel endotel dan sel makrofag/granulosit yang lebih
besar pula, sehingga terjadi reaksi inflamasi menimbulkan gejala – gejala pre
eklamsia pada ibu.</span></div>
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<br /></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">3.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Patofisiologi</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Menurut Bobak (2004) adaptasi
fisiologi normal pada kehamilan meliputi peningkatan volume plasma darah,
vasodilatasi, penurunan resistensi vaskular sistemik (systemic vascular
resistance [SVR]), peningkatan curah jantung dan penurunan tekanan osmotik koloid.
Pada pre eklamsia, volume plasma yang beredar menurun, sehingga <b style="mso-bidi-font-weight: normal;">hemokonsentrasi</b> dan peningkatan
hematokrit maternal. Perubahan ini membuat perfusi organ maternal menurun,
termasuk perfusi ke unit janin uteroplasenta. Vasospasme siklik lebih lanjut
menurunkan perfusi organ dengan menghancurkan sel – sel darh merah, sehingga
kapasitas oksigen maternal menurun. Vasopasme merupakan sebagian mekanisme
dasar tanda dan gejala yang menyertai pre eklamsia. Vasopasme merupakan akibat
peningkatan sensitivitas terhadap tekanan peredaran darah, seperti angiotensin
II dan kemungkinan suatu ketidak seimbangan abtara prostasiklin <b style="mso-bidi-font-weight: normal;">prostaglandin</b> dan tromboksan A2.
Selain kerusakan endotelil vasospasme arterial turut menyebabkan peningkatan
permeabilitas kapiler. Keadaan ini meningkatkan edema dan lebih lanjut
menurunkan volume intra vaskular, mempredisposisi pasien yang mengalami pre
eklamsia mudah menderita edema paru.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> Hubungan sistem imun dengan
pre eklamsia menunjukkan bahwa faktor-faktor imunologi memainkan peran penting
dalam perkembangan pre eklamsia. Keberadaan protein asing, plasenta, atau janin
bisa membangkitkan <b style="mso-bidi-font-weight: normal;">respons imunologis</b>
lanjut. Teori ini di dukung oleh peningkatan insiden pre eklamsia-eklamsia pada
ibu baru (pertama kali terpapar jaringan janin) dan pada ibu hamil dari
pasangan yang baru (materi genetik yang berbeda).</span></div>
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;"> Menurut Mochtar (2007) Pada preeklamsia
terjadi spasme pembuluh darah disertai dengan retensi garam dan air. Pada
biopsi ginjal ditemukan spasme hebat arteriola glomerolus. Pada beberapa kasus,
lumen arteriola sedemikian sempitnya sehingga hanya dapat dilalui oleh satu sel
darah merah. Jadi jika semua arteriola dalam tubuh mengalami spasme, maka
tekanan darah akan naik, sebagai usaha untuk mengatasi </span></div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0tag:blogger.com,1999:blog-3349280287025837119.post-4551904834418147962013-01-10T20:24:00.002-08:002013-01-10T20:24:36.119-08:00Pre-Eklamsi Hal 3<div dir="ltr" style="text-align: left;" trbidi="on">
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">membran sel yang banyak mengandung asam lemak tidak jenuh
menjadi peroksida lemak. Periksida lemak juga akan merusak nukleus dan protein
sel endotel</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">b.Disfungsi Endotel</span></div>
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<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Kerusakan membran sel endotel mengakibatkan terganggunya
fungsi endotel, bahkan rusaknya seluruh struktur sel endotel keadaan ini
disebut disfungsi endotel, yang akan menyebabkan terjadinya :</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 78.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.3pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">a) Gangguan
metabolisme prostalglandin, yaitu menurunnya produksi <b style="mso-bidi-font-weight: normal;">prostasiklin</b> (PGE2) yang merupakan suatu vasodilator kuat.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 78.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.3pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">b) Agregasi
sel-sel trombosit pada daerah endotel yang mengalami kerusakan. Agregasi
trombosit memproduksi tromboksan (TXA2) yaitu suatu vasokonstriktor kuat. Dalam
keadaan normal kadar prostasiklin lebih banyak dari pada tromboksan. Sedangkan
pada pre eklamsia kadar tromboksan lebih banyak dari pada prostasiklin,
sehingga menyebabkan peningkatan tekanan darah.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 78.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.3pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">c) Perubahan khas
pada sel endotel kapiler glomerulus (glomerular endotheliosis) .</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 78.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.3pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">d) Peningkatan <b style="mso-bidi-font-weight: normal;">permeabilitas kapiler</b>.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 78.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.3pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">e) Peningkatan
produksi bahan – bahan vasopresor, yaitu endotelin. Kadar NO menurun sedangkan
endotelin meningkat.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 78.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify; text-indent: -21.3pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">f)
Peningkatan faktor <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314088/koagulasi.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">koagulasi</b></a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">3) Teori
intoleransi imunologik ibu dan janin</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Pada perempuan normal respon imun tidak menolak adanya hasil
konsepsi yang bersifat asing. Hal ini disebabkan adanya Human Leukocyte Antigen
Protein G (HLA-G) yang dapat melindungi trofoblas janin dari lisis oleh sel
natural killer (NK) ibu. HLA-G juga akan mempermudah invasis el trofoblas
kedalam jaringan desidua ibu. Pada plasenta ibu yang mengalami pre eklamsia
terjadi ekspresi penurunan HLA-G yang akan mengakibatkan terhambatnya invasi
trofoblas ke dalam desidua. Kemungkinan terjadi <b style="mso-bidi-font-weight: normal;">Immune-Maladaptation</b> pada pre eklamsia.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">4) Teori Adaptasi
kardiovaskular</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Pada kehamilan normal pembuluh darah refrakter terhadap
bahan vasopresor. Refrakter berarti pembuluh darah tidak peka terhadap
rangsangan vasopresor atau dibutuhkan kadar vasopresor yang lebih tinggi untuk
menimbulkan respon vasokonstriksi. Refrakter ini terjadi akibat adanya sintesis
<b style="mso-bidi-font-weight: normal;">prostalglandin</b> oleh sel endotel.
Pada pre eklamsia terjadi kehilangan kemampuan refrakter terhadap bahan
vasopresor sehingga pembuluh darah menjadi sangat peka terhadap bahan <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314299/VASOSPASME.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">vasopresor</b></a> sehingga pembuluh darah akan
mengalami vasokonstriksi dan mengakibatkan hipertensi dalam kehamilan.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> 5) Teori
Genetik</span></div>
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">Ada faktor keturunan dan familial dengan model
gen tunggal. <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314052/genotype.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">Genotype</b></a> ibu lebih
menentukan terjadinya hipertensi dalam kehamilan secara familial jika
dibandingkan dengan genotype janin. Telah terbukti bahwa ibu yang mengalami </span></div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0tag:blogger.com,1999:blog-3349280287025837119.post-18875126897581171082013-01-10T20:20:00.001-08:002013-01-10T20:20:41.160-08:00Pre-Eklamsia Hal 2<div dir="ltr" style="text-align: left;" trbidi="on">
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<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">semakin sempurna pada kehamilan
berikutnya. Beberapa data yang mendukung adanya sistem imun pada penderita
PE-E, beberapa wanita dengan PE-E mempunyai komplek imun dalam serum, beberapa
studi juga mendapatkan adanya aktifasi sistem komplemen pada PE-E diikuti
proteinuria (Rukiyah, 2010).</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">3) Faktor genetik</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Beberapa bukti menunjukkan peran
faktor genetik pada kejadian PE-E antara lain : (1) preeklamsia hanya terjadi
pada manusia; (2) terdapatnya kecenderungan meningkatnya frekuensi PE-E pada
anak-anak dari ibu yang menderita PE-E; (3) kescenderungan meningkatnya
frekuensi PE-E pada anak dan cucu ibu hamil dengan riwayat PE-E dan bukan pada
ipar mereka; (4) peran <b><a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314162/pages9-20.pdf.html">renin-angiotensin-aldosteron</a></b> sistem (RAAS) (Rukiyah, 2010).</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> Yang jelas preeklamsia
merupakan salah satu penyebab kematian pada ibu hamil, disamping infeksi dan
perdarahan, Oleh sebab itu, bila ibu hamil ketahuan beresiko, terutama sejak
awal kehamilan, dokter kebidanan dan kandungan akan memantau lebih ketat
kondisi kehamilan tersebut.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> Beberapa penelitian
menyebutkan ada beberapa faktor yang dapat menunjang terjadinya preeklamsia dan
eklamsia. Faktor-faktor tersebut antara lain,gizi buruk, kegemukan, dan
gangguan aliran darah kerahim. Faktor resiko terjadinya preeklamsia,
preeklamsia umumnya terjadi pada kehamilan yang pertama kali, kehamilan di <b style="mso-bidi-font-weight: normal;">usia remaja</b> dan kehamilan pada wanita
diatas usia 40 tahun. Faktor resiko yang lain adalah riwayat tekanan darah
tinggi yang kronis sebelum kehamilan, riwayat mengalami preeklamsia sebelumnya,
riwayat preeklamsia pada ibu atau saudara perempuan, kegemukan,mengandung lebih
dari satu orang bayi, riwayat kencing manis, kelainan ginjal, <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314163/lupus.pdf.html"><b style="mso-bidi-font-weight: normal;">lupus</b></a> atau <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314278/rematroidatritis.pdf.html"><b style="mso-bidi-font-weight: normal;">rematoid artritis</b> </a>(Rukiyah 2010).</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> Sedangkan menurut Angsar
(2008) teori – teorinya sebagai berikut:</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">1) Teori kelainan
vaskularisasi plasenta</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Pada kehamilan normal, rahim dan plasenta mendapatkan aliran
darah dari cabang – cabang arteri uterina dan arteri ovarika yang menembus
miometrium dan menjadi arteri arkuata, yang akan bercabang menjadi arteri
radialis. Arteri radialis menembus endometrium menjadi arteri basalis memberi
cabang arteri spiralis. Pada kehamilan terjadi invasi trofoblas kedalam lapisan
otot arteri spiralis, yang menimbulkan degenerasi lapisan otot tersebut
sehingga terjadi distensi dan <b style="mso-bidi-font-weight: normal;">vasodilatasi</b>
arteri spiralis, yang akan memberikan dampak penurunan tekanan darah, penurunan
resistensi vaskular, dan peningkatan aliran darah pada utero plasenta.
Akibatnya aliran darah ke janin cukup banyak dan perfusi jaringan juga
meningkat, sehingga menjamin pertumbuhan janin dengan baik. Proses ini
dinamakan remodelling <b style="mso-bidi-font-weight: normal;">arteri spiralis</b>.
Pada pre eklamsia terjadi kegagalan remodelling menyebabkan arteri spiralis
menjadi kaku dan keras sehingga arteri spiralis tidak mengalami distensi dan
vasodilatasi, sehingga aliran darah utero plasenta menurun dan terjadilah hipoksia
dan iskemia plasenta.</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> 2) Teori <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314053/iskemik.pdf.html"><b style="mso-bidi-font-weight: normal;">Iskemia</b></a> Plasenta, <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314276/Radikalbebas.pdf.html"><b style="mso-bidi-font-weight: normal;">Radikal bebas</b></a>, dan Disfungsi Endotel</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 36.0pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">a.Iskemia Plasenta dan pembentukan Radikal Bebas</span></div>
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">Karena kegagalan Remodelling arteri spiralis
akan berakibat plasenta mengalami iskemia, yang akan merangsang pembentukan
radikal bebas, yaitu radikal hidroksil (-OH) yang dianggap sebagai toksin.
Radiakl hidroksil akan merusak </span></div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0tag:blogger.com,1999:blog-3349280287025837119.post-40783467666608715892013-01-10T20:15:00.003-08:002013-01-10T20:15:29.215-08:00Pre-Eklamsi Hal 1<div dir="ltr" style="text-align: left;" trbidi="on">
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<b><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">PRE-EKLAMSI KEHAMILAN </span></b><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 21.3pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo1; text-align: justify; text-indent: -21.3pt;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: Arial;"><span style="mso-list: Ignore;">1.<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Definisi pre eklamsi</span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Pre eklamsia adalah keadaan dimana
hipertensi disertai dengan proteinuria, edema atau kedua-duanya yang terjadi
akibat kehamilan setelah minggu ke 20 atau kadang-kadang timbul lebih awal bila
terdapat perubahan hidatidiformis yang luas pada vili dan korialis (<b style="mso-bidi-font-weight: normal;">Mitayani</b>, 2009).</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Preeklamsi adalah penyakit dengan
tanda-tanda hipertensi, proteinuria, dan edema yang timbul karena kehamilan.
Penyakit ini umumnya terjadi dalam triwulan ke tiga pada kehamilan, tetapi
dapat terjadi sebelumnya misalnya pada <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314161/molahidatidosa.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">molahidatidosa</b></a>. (Rukiyah, 2010).</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><a href="http://www.ziddu.com/download/21314220/preeklampsia.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;"><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Preeklampsia</span></b></a><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"><a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314220/preeklampsia.pdf.html" target="_blank"></a>merupakan suatu kondisi spesifik kehamilan dimana <b style="mso-bidi-font-weight: normal;">hipertensi</b> terjadi setelah minggu ke-20 pada wanita yang sebelumnya
memiliki tekanan darah normal. (Bobak , 2004)</span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Pre eklamsia adalah timbulnya
hipertensi disertai <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314219/Proteinuria.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">proteinnuria</b></a> dan
atau edema setelah umur kehamilan 20 minggu atau segera setelah persalinan.
Gejala ini dapat timbul sebelum umur kehamilan 20 minggu pada penyakit
trofoblas. (Sujiyatini, 2009)</span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo2; text-align: justify; text-indent: -18.0pt;">
<span style="font-family: Symbol; font-size: 12.0pt; mso-bidi-font-family: Symbol; mso-fareast-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt "Times New Roman";">
</span></span></span><span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Pre eklamsia dapat dideskripsikan
sebagai kondisi yang tidak dapat diprediksi dan progresif serta berpotensi
mengakibatkan disfungsi dan gagal multi organ yang dapat mengganggu kesehatan
ibu dan berdampak negative pada lingkungan janin. (Boyle M, 2007)</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> <b style="mso-bidi-font-weight: normal;">Etiologi</b></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Penyebab pre eklamsia saat ini tak
bisa diketahui dengan pasti, walaupun penelitian yang dilakukan terhadap
penyakit ini sudah sedemikian maju. Semuanya baru didasarkan pada teori yang
dihubungkan dengan kejadian. Itulah sebab pre eklamsia disebut juga “<b style="mso-bidi-font-weight: normal;">disease of theory</b>” (Rukiyah, 2010).</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> Teori yang dapat diterima
haruslah dapat menerangkan hal – hal berikut : (1) sebab bertambahnya frekuensi
pada <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314217/pimigravida.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">primigravida</b></a>, kehamilan ganda,
hidramnion, dan <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314161/molahidatidosa.pdf.html" target="_blank"><b style="mso-bidi-font-weight: normal;">molahidatidosa</b></a>; (2)
sebab bertambahnya frekuensi dengan makin tuanya kehamilan; (3) sebab dapat
terjadinya perbaiakan keadaan penderita dengan kematian janin dalam uterus; (4)
sebab jarangnya terjadi eklamsia pada kehamilan-kehamilan berikutnya; dan (5)
sebab timbulnya hipertensi, edema, proteinuria, kejang dan koma. (Hanifa W, 2006).</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";"> Dari hal-hal tersebut diatas,
jelaslah bahwa bukan hanya satu faktor, melainkan banyak faktor yang
menyebabkan pre-eklamsia dan <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314021/eklampsia.pdf.html"><b style="mso-bidi-font-weight: normal;">eklamsia</b>.</a></span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Adapun teori-teori yang dihubungkan
dengan terjadinya preeklamsia adalah:</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">1) Peran <b style="mso-bidi-font-weight: normal;">prostasiklin</b> dan trombiksan</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">Pada preeklamsia didapatkan
kerusakan pada endotel vaskular, sehingga terjadi penurunan produksi
prostsiklin (PGI 2) yang pada kehamilan normal meningkat, aktifasi pengumpulan
dan fibrinolisis, yang kemudian akan digant trombin dan plasmin,trombin akan mengkonsumsi
anti trombin III, sehingga terjadi deposit fibrin. Aktifasi trombosit
menyebabkan pelepasan tromboksan (TXA2) dan serotonin, sehingga terjadi <a href="http://www.blogger.com/%09http://www.ziddu.com/download/21314299/VASOSPASME.pdf.html"><b style="mso-bidi-font-weight: normal;">vasospasme</b></a> dan kerusakan endotel
(Rukiyah, 2010).</span></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; mso-fareast-font-family: "Times New Roman";">2) Peran faktor
imunologis</span></div>
<span style="font-family: "Arial","sans-serif"; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: EN-US;">Preeklamsia sering terjadi pada kehamilan
pertama dan tidak timbu lagi pada kehamilan berikutnya. Hal ini dapat
ditererangkan bahwa pada kehamilan pertama pembentukan blocking antibodies
terhadap antigen plasenta tidak sempurna, yang </span><br />
<br />
</div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0tag:blogger.com,1999:blog-3349280287025837119.post-5743081569776821822013-01-08T20:10:00.002-08:002013-01-08T21:08:58.057-08:00Bahaya Celana Ketat Bagi Wanita<div dir="ltr" style="text-align: left;" trbidi="on">
Allah Subhanahu wa Ta’ala berfirman, “Hai nabi, katakanlah kepada istri-istrimu, anak-anak perempuanmu dan istri-istri orang mukmin, ‘Hendaklah mereka mengulurkan jilbabnya ke seluruh tubuh mereka,’ yang demikian itu supaya mereka lebih mudah untuk dikenal. Karena itu, mereka tidak diganggu. Dan Allah adalah Maha Pengampun lagi Maha Penyayang.” (QS. Al-Ahzab: 59)<br />
Sudah menjadi pemandangan yang biasa dimana sebagian besar wanita di negeri ini berkeliaran di jalan-jalan tanpa menutup aurat mereka. Mereka keluar dari rumah-rumahnya dengan pakaian yang sebenarnya tidak layak disebut sebagai pakaian. Pakaian memiliki fungsi untuk menutup aurat, melindungi tubuh manusia dari kondisi lingkungan dan cuaca disekitarnya. Ia melindungi tubuh manusia dari kondisi lingkungan yang berdebu, lembab, atau kering. Pakaian juga melindungi tubuh dari cuaca yang senantiasa berubah panas ataupun dingin. Pakaian adalah kulit kedua manusia. Namun sangat disayangkan, fungsi pakaian sudah banyak berubah. Pakaian sudah tidak lagi memenuhi fungsi sebagai kulit kedua tubuh manusia. Ia kini lebih berperan sebagai penghias dan aksesoris tubuh manusia. Bahkan tidak jarang banyak wanita yang bangga berperilaku menyerupai kera atau sapi, tidak berpakaian (misal: di film, website, atau tabloid). Mereka menganggap bahwa pakaian ketat nan seksi identik dengan modern. Tentu pemikiran tersebut salah besar. Modern identik dengan kemajuan cara berpikir ilmiah dalam ilmu pengetahuan.<a href="http://www.ziddu.com/download/21297890/BahayaPakaianKetat.pdf.html" target="_blank">Untuk Lebih Lengkapnya, Klik here</a><br />
<br />
Tulisan ini juga dapat dibaca pada blog saya yang lain (<a href="http://aidillaadha.wordpress.com/?p=7&preview=true" target="_blank">Klik)</a></div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0tag:blogger.com,1999:blog-3349280287025837119.post-68963628007802007912012-12-20T23:34:00.004-08:002012-12-20T23:34:50.039-08:00<div dir="ltr" style="text-align: left;" trbidi="on">
<h2 class="entry-title" itemprop="name">
Cara mengetahui Pengintip Facebook kita (new Method)</h2>
<time class="entry-date" datetime="2012-12-03" itemprop="datePublished"> </time>Ini adalah cara untuk mengetahui orang yang sering melihat profile facebook Agan-Aganwati :<br /><br />1.Masuk / login ke facebook.<br /><br />2.Lalu di halaman facebook, pilih area dimana saja KECUALI di area GAMBAR:<br /><br />klik
kanan mouse - kemudian pilih " VIEW PAGE SOURCE". karena browser Ane
memakai bahasa english maka tulisan tsb juga english " VIEW PAGE
SOURCE". Mungkin Agan yg pakai browser bhs Indonesia tulisannya berupa:
"LIHAT SUMBER HALAMAN".<br />Harap agan/aganwati perhatikan: Klik kanan tidak boleh di area "GAMBAR".<br /><br /><img alt="" border="0" height="200" src="file:///F:/Cara%20mengetahui%20Pengintip%20Facebook%20kita%20%28new%20Method%29%20_%20Kaskus%20-%20The%20Largest%20Indonesian%20Community_files/sourcethree.jpg" width="200" /><br /><br /><br />3.Nanti akan keluar halaman baru dgn tulisan spt gambar dibawah Gan:<br /><img alt="" border="0" height="200" src="file:///F:/Cara%20mengetahui%20Pengintip%20Facebook%20kita%20%28new%20Method%29%20_%20Kaskus%20-%20The%20Largest%20Indonesian%20Community_files/pagesource.jpg" width="200" /><br /><br /><br />4.Setelah itu Agan tekan tombol keyboard berbarengan: "CTRL" + "F". Ini tombol untuk search / mencari.<br /><br />Lalu isi dikolom search tsb tulisan: ORDEREDFRIENDS , kemudian tekan ENTER.<br /><br /><img alt="" border="0" height="200" src="file:///F:/Cara%20mengetahui%20Pengintip%20Facebook%20kita%20%28new%20Method%29%20_%20Kaskus%20-%20The%20Largest%20Indonesian%20Community_files/orderedfriends.jpg" width="200" /><br /><br />5.Maka Mouse akan mendarat di tulisan yg kita cari tsb: ORDEREDFRIENDS.<br /><br />6. Terus agan lihat disebelah kanannya ada angka-angka, Misalkan:<br /><br />"OrderedFriendsListInitialData",[],{"list":["110000192251234","151176584","110043792251234",<br /><br />Angka-angka tersebut adalah PROFILE NUMBER yg suka ngintip PROFILE Agan - Aganwati.<br /><br /><br />7.Cara mengetahui siapa ORANG tsb maka masukan saja angkanya dibelakang <a href="http://www.facebook.com/" target="_blank">www.facebook.com/</a> , dengan cara spt ini:<br /><br /><a href="http://www.facebook.com/110000192251234" target="_blank">http://www.facebook.com/110000192251234</a> Lalu tekan ENTER.<br /><br />Maka akan keluar PROFILE yg sering MENGINTIP Profile facebook Agan-Aganwati.<br />Angka pertama yg PALING sering ngintip Gan, diikuti dengan angka selanjutnya.<br /><br />Bisa dilanjutkan ke ORANG KEDUA yang sering ngintip profile Agan - Aganwati, dengan cara yang sama.<br /><br />Yaitu masukan deretan angka kedua setelah koma , contoh: 151176584<br /><br /><br />Happy Hunting,</div>
Anonymoushttp://www.blogger.com/profile/06353027919924533234noreply@blogger.com0