tag:blogger.com,1999:blog-67308071327252397612024-02-06T21:31:51.178-08:00blognyadeviKUMPULAN MATERI KULIAHKUDEVIANAhttp://www.blogger.com/profile/01031644635327768252noreply@blogger.comBlogger12125tag:blogger.com,1999:blog-6730807132725239761.post-51841030601580128502010-01-12T08:08:00.000-08:002010-01-12T08:42:20.725-08:00PERSALINAN PREMATUR<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIaQEw0n-ISpuuqyrezlwW6dql3Q0t7ZHRp5xdXP2fH_vQMHnqS5HDfV8nA6qCg9OXZAnLqNJzin2vVP3IARss_7msfTb4rYG2lfUvp1pJlW4EMh3mel0_2U64SOBqiZyJUObhr6wQdqk2/s1600-h/Picture1.png"><img id="BLOGGER_PHOTO_ID_5425890828245945154" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 152px; CURSOR: hand; HEIGHT: 209px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIaQEw0n-ISpuuqyrezlwW6dql3Q0t7ZHRp5xdXP2fH_vQMHnqS5HDfV8nA6qCg9OXZAnLqNJzin2vVP3IARss_7msfTb4rYG2lfUvp1pJlW4EMh3mel0_2U64SOBqiZyJUObhr6wQdqk2/s320/Picture1.png" border="0" /></a><br /><br /><br /><p><br />Merupakan persalinan yang terjadi pada kehamilan <> <p></p><p></p><p></p><p align="center"><span style="font-size:180%;">Masalah :<br /></span></p><p align="center"><span style="color:#3333ff;">Perawatan bayi<br /></span></p><p align="center"><span style="color:#3333ff;">Mortalitas & morbiditas tinggi<br /></span></p><p align="center"><span style="color:#3333ff;">Kualitas hidup </span></p><br /><br /><br /><p align="center"><span style="color:#ff0000;">70% anak yang dilahirkan prematur & bertahan hidup : gangguan pernapasan & neurologis baik jangka pendek maupun jangka panjang, seperti displasia bronkopulmo, cerebral palsy, perdarahan intra-ventrikel, patent ductus arteriosus, dan gangguan perkembangan intelegensia</span> </p><br /><br /><br /><p><span style="color:#3333ff;">Kecil untuk Masa Kehamilan (KMK, <em>small for date</em>)</span> : </p><p>bila berat lahirnya kurang dari 10 persentil. </p><br /><p>Sulit membedakan dengan prematur </p><br /><p>Seringkali prematur disertai dengan KMK </p><br /><br /><br /><p>PENYEBAB<br />50% spontan<br /><br />30% ketuban pecah dini (KPD) </p>20% indikasi ibu & janin<br /><br /><br /><br /><p>Penyebab tersering : multifaktorial </p>Merupakan komplikasi medis/obstetris<br /><br />Perdarahan<br /><br />KJDR, kelainan kongenital<br /><br />KPD, infeksi<br /><br />Plasentasi yang kurang baik<br /><br />Distensi uterus, oligohidramnion<br /><br />Riwayat prematur atau abortus<br /><br />Inkompetensi serviks<br /><br />Penyakit ibu<br /><br />Malnutrisi : anemia, kekurangan asam folat & Zn<br /><br />Penambahan berat badan kurang saat kehamilan<br /><br />Anomali uterus atau fibroid<br /><br />Faktor sosiobudaya<br /><br />Perokok atau penyalahgunaan obat<br /><br />Kemiskinan<br /><br />Pendek-kurus<br /><br />Umur <18>40 thn<br /><br />ANC tidak teratur<br /><br />Keturunan<br /><br />Ras kulit hitam<br /><br /><br /><br /><p></p><br /><br /><br /><p>PENILAIAN KLINIK </p>Kriteria persalinan prematur<br />Kontraksi yang teratur dengan jarak 7 – 8 menit atau kurang disertai pelepasan lendir kemerahan atau cairan pervaginam, dan diikuti oleh :<br /><br /><br /><br /><br /><p>Pada periksa dalam :<br />• Pendataran 50 – 80%<br />• Pembukaan ≤ 2 atau lebih<br />• USG :<br /> Panjang serviks kurang 2 cm<br /><br />PENANGANAN </p>Perlu penilaian tentang :<br /> Usia kehamilan, demam atau tidak, kondisi janin (jumlah, letak, tbj, hidup, mati, gawat<br /> janin, kelainan kongenital), letak plasenta, fasilitas dan petugas<br /><br /><br /><p>Prinsip penanganan : </p><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUeVGaUA_3WtrAOb1b5VrM_oByFrtdfEIaXBsflycHXNUiskd3oiWSahgTiYHeRwt0u1sO8JKVXZgPrP8WKoaJbWRso3_V3R2zbbpgS7vjbCNa9aNHCXDWKQz4ECC1igfA8q7T4Dq-dzi1/s1600-h/tokolitik.png"><img id="BLOGGER_PHOTO_ID_5425890828636479730" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 685px; CURSOR: hand; HEIGHT: 401px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUeVGaUA_3WtrAOb1b5VrM_oByFrtdfEIaXBsflycHXNUiskd3oiWSahgTiYHeRwt0u1sO8JKVXZgPrP8WKoaJbWRso3_V3R2zbbpgS7vjbCNa9aNHCXDWKQz4ECC1igfA8q7T4Dq-dzi1/s320/tokolitik.png" border="0" /></a><br /><br /><p>1. Hentikan kontraksi uterus → tokolitik </p>2. Pematangan paru : usia kurang 32 mgg<br /> • Dexametason 5 mg/im/6 jam :4 dosis<br /> • Betametason 12 mg/im/12 : 2 dosis<br /><br />3. Antibiotik<br /><br /><br /><br /><p>Bila persalinan tetap berlangsung → penanganan persalinan</p>Intervensi bertujuan untuk menunda kelahiran sampai bayi cukup matang.<br /><br /><br /><br /><p>Penundaan dilakukan bila : </p>l. Usia kehamilan kurang 35 minggu <div><br />2. Pembukaan serviks kurang 3 cm <div><br />3. Tidak ada amnionitis, preeklampsia atau perdarahan aktif </div><div><br />4. Tidak ada gawat janin </div><div><br /><br /></div><p></p><div>Obat tokolitik </div><div><br />Tokolitik tidak diberikan pada keadaan: </div><div><br />l. Usia kehamilan > 35 minggu<br />2. Pembukaan > 3 cm<br />3. Perdarahan aktif<br />4. Janin mati atau ada kelainan kongenital dengan kemungkinan hidup kecil<br />5. Korioamnitis<br />6. Preeklampsia<br />7. Gawat janin<br /><br />Pantau kemajuan persalinan dengan partograf<br />Hindari penggunaan vakum<br />Persiapkan pertolongan bayi prematur<br /></div><div>Tindakan saat postpartum<br />- Usahakan lingkungan yang hangat<br />- Metode kanguru<br />- Inkubator<br />- Oksigen<br />- ventilasi<br /><br /></div></div>DEVIANAhttp://www.blogger.com/profile/01031644635327768252noreply@blogger.com0tag:blogger.com,1999:blog-6730807132725239761.post-61767993458481162392009-12-13T01:23:00.005-08:002009-12-29T07:15:30.574-08:00INFERTILITAS<p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style=" font-weight: bold; font-family:Constantia;font-size:medium;">DEFINISI</span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"></span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>American Fertility Society (AFC)</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Ketidak mampuan pasturi untuk menghasilkan kehamilan setelah 1 tahun kawin <span class="Apple-tab-span" style="white-space:pre"> </span>dengan hubungan teratur dan tanpa alat kontrasepsi</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"></span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>WHO</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Ketidak mampuan pasturi untuk menghasilkan kehamilan setelah 2 tahun kawin <span class="Apple-tab-span" style="white-space:pre"> </span>dengan hubungan teratur dan tanpa alat kontrasepsi</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style=" ;font-family:Constantia;">Peluang Keberhasilan</span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">85 - 90 % wanita akan hamil selama 1 thn masa perkawinannya</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">10 - 15 % menjadi infertil</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"></span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Klasifikasi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Infertilitas :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Primer <span class="Apple-style-span" style="font-family:'Monotype Sorts';"> : </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">belum pernah hamil</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Sekunder : sdh pernah hamil</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Constantia;"><br /></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style=" font-weight: bold; font-family:Constantia;"><span class="Apple-style-span" style="font-size:large;">Syarat untuk terjadi kehamilan :</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> Testis menghasilkan sperma</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> Ovarium menghasilkan ovum</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> Tuba fallopii paten</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> Endometrium/uterus mampu menunjang/mempertahankan kehamilan</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Lendir serviks normal</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"></span></span></span><b><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">PENYEBAB INFERTIL :</span></span></b><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Constantia;"><b><br /></b></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">1. Faktor pria : </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - 25-30% kasus infertilitas</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Kelainan : - Infeksi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Kel. Kongenital</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Ggn Hormonal</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Autoimun</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Varikokel </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Constantia;"><br /></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">2. Faktor </span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> </span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">ovulasi :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Anovulasi : </span><u><span class="Apple-style-span" style="font-size:medium;">+</span></u><span class="Apple-style-span" style="font-size:medium;"> 15- 20%</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - E/ : - Kel. Genetik</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Hiperprolaktinemia</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Hipo/Hiper tiroid</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Faktor stress</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Berat badan</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Peny. Ovarium Polikistik</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">3. Faktor serviks (mulut rahim)</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><u><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">+</span></span></u><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> 2 - 5 %</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Fungsi serviks</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Filter : Bakteri dan Spermatozoa yang kurang baik</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Reservoir : spermatozoa hidup </span><u><span class="Apple-style-span" style="font-size:medium;">+</span></u><span class="Apple-style-span" style="font-size:medium;"> 2 hari</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">E/kelainan fungsi serviks :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Kel anatomi : posisi retroversi, serviks panjang</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Infeksi kronis : Gangguan produksi lendir serviks</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Kel. Imunologi : antibodi anti sperma</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">4. Faktor tuba</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><u><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">+</span></span></u><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> 25-40 %</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Fungsi tuba : menangkap ovum</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Transportasi : Sperma, hasil fertilisasi dan zygote</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">E/Kelainan fungsi tuba :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Infeksi : Salpingitis dan hidrosalping </span></span><span style=" ;font-family:'Monotype Sorts';"><span class="Apple-style-span" style="font-size:medium;">þ</span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> mukosa dan silia tuba</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Perlengketan peritubal dan periovarium </span></span><span style=" ;font-family:'Monotype Sorts';"><span class="Apple-style-span" style="font-size:medium;">þ</span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> ovum pick up</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Endometriosis</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Kel. kongenital</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">5. Faktor uterus</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><u><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">+</span></span></u><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> 5 - 10 %</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Fungsi uterus : </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> ~ Transportasi sperma</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> ~ Implantasi dan nidas</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> ~ Pemeliharaan hasil kehamilan</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">E/Infertilitas :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> ~ Kel. Anatomi : </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Kel. Kongenital</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Adesi intrauteri</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Mioma uteri</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Kerusakan endometrium</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> ~ Polip endometrium</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> ~ Hiperplasia endometrium</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">6. Faktor peritoneum / endometrium</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Endometriosis : </span><u><span class="Apple-style-span" style="font-size:medium;">+</span></u><span class="Apple-style-span" style="font-size:medium;"> 15 - 25 wanita infertilitas</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Infertilitas yang tidak diketahui penyebab : </span><u><span class="Apple-style-span" style="font-size:medium;">+</span></u><span class="Apple-style-span" style="font-size:medium;"> 70 - 80 % endometriosis</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Patogenesis</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Endometriosis </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.3in;margin-bottom:.0001pt;text-align:left; text-indent:-16.55pt;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Ringan & sedang belum jelas</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.3in;margin-bottom:.0001pt;text-align:left; text-indent:-16.55pt;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Berat perlengketan dan distorsi anatomik</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Gangguan proses maturasi folikel</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Ovum pick up</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Transportasi hasil konsepsi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Efek toksik dari cairan peritoneum</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">7. Faktor Idiopatik</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><u><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">+</span></span></u><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> 10 - 15 % tidak diketahui E/</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Infertilitas idiopatik/Unexplained infertility</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Jika semua pemeriksaan standart infertilitas normal</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><b><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">PEMERIKSAAN</span></span></b></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style=" ;font-family:Constantia;font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Anamnesis</span><br /><span class="Apple-style-span" style=" ;font-family:Constantia;font-size:medium;">Pem. Fisis/ginekologis</span><br /><span class="Apple-style-span" style=" ;font-family:Constantia;font-size:medium;">Analisis sperma</span><br /><span class="Apple-style-span" style=" ;font-family:Constantia;font-size:medium;">Deteksi ovulasi</span><br /><span class="Apple-style-span" style=" ;font-family:Constantia;font-size:medium;">Uji paska sanggama</span><br /><span class="Apple-style-span" style=" ;font-family:Constantia;font-size:medium;">HSG</span><br /><span class="Apple-style-span" style=" ;font-family:Constantia;font-size:medium;">Laparoskopi</span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><b><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-style-span" style="font-weight: normal; "><span class="Apple-style-span" style="font-weight: bold; ">ANAMNESIS</span></span></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Umur pasturi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Lama perkawinan, lama usaha untuk hamil, perkawinan keberapa, apakah perkawinan <span class="Apple-tab-span" style="white-space:pre"> </span>sebelumnya menghasilkan anak</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> Riw. siklus haid dan umur menarke</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> Riw. Kehamilan atau persalinan yang lalu, alat kontrasepsi,penyakit yang diderita, riw <span class="Apple-tab-span" style="white-space:pre"> </span>pembedahan</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> Kenaikan & penurunan BB</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Aktifitas & latihan fisik yang berlebihan</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Stress emosional</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Apakah ada hirsutisme & galaktorea</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><b><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Pem. Fisis / Ginekologi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Hirsutisme dan jerawat</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Pembesaran kel. Tiroid</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Galaktorea</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Inspeksi lendir serviks <span class="Apple-style-span" style="font-family:'Monotype Sorts';"> : </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">kualitas mukus</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Pemeriksaan bimanual :</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Tumor uterus / adneksa</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"></span></span></span><b><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Pemeriksaan penunjang</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">1. Analisis Sperma :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Jumlah </span><u><span class="Apple-style-span" style="font-size:medium;">></span></u><span class="Apple-style-span" style="font-size:medium;"> 20 juta/ml</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Morfologi </span><u><span class="Apple-style-span" style="font-size:medium;">></span></u><span class="Apple-style-span" style="font-size:medium;"> 40 %</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Mortil </span><u><span class="Apple-style-span" style="font-size:medium;">></span></u><span class="Apple-style-span" style="font-size:medium;"> 60 %</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">2. Deteksi ovulasi :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Anamnesis siklus menstruasi</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>90 % siklus mens teratur :siklus ovulatoar</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Pem. Suhu badan basal :</span><span class="Apple-style-span" style="font-size:medium;"> </span><span class="Apple-style-span"><span class="Apple-style-span" style="font-size:medium;">meningkat 0,6 - 1</span><sup><span class="Apple-style-span" style="font-size:medium;">o</span></sup><span class="Apple-style-span" style="font-size:medium;">C setelah ovulasi (Bifasik)</span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Uji benang lendir serviks dan uji pakis</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Sesaat sebelum ovulasi : lendir serviks encer, </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>daya membenang lebih panjang, pembentukan gambaran daun pakis</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span>Estradiol meningkat</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"></span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Deteksi ovulasi (lanjutan)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">BIOPSI ENDOMETRIUM</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">HORMONAL</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">FSH, LH, E2, </span></span><st1:stockticker><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">PROG</span></span></st1:stockticker><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">ESTERON, PROLAKTIN</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"></span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Biopsi endometrium</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Beberapa hari menjelang haid </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Endometrium fase sekresi : siklus ovulatoar</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span>Endometrium fase proliferasi/gbran</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span>Hiperplasia : siklus Anovulatoar</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Efek progesteron</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"></span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span> Hormonal</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:'Monotype Sorts';"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Hormon yang mempengaruhi </span></span><span lang="IN" style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> </span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">pertumbuhan dan perkembangan </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>folikel :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span>* FSH serum : 10 - 60 mIU/ml</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span>* LH serum : 15 - 60 mIU/ml</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span>* Estradiol : 200 - 600 pg/ml</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span> * Progesteron : 5 - 20 mg/ml</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span> * Prolaktin : 2 - 20 mg/ml</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"></span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>USG transvaginal</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span> * Secara serial : adanya ovulasi dan perkiraan saat ovulasi</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span>* Ovulasi : ukuran folikel 18 - 24 m</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo9;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:'Times New Roman';"><span class="Apple-style-span" style="font-size:medium;">ø</span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> FOLIKEL DOMINAN 18-24 mm</span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><br /></span><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">2. Uji paska sanggama (</span></span><st1:stockticker><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">UPS</span></span></st1:stockticker><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> Syarat :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Pem. Lendir serviks </span><u><span class="Apple-style-span" style="font-size:medium;">+</span></u><span class="Apple-style-span" style="font-size:medium;"> 6 - 10 jam paska sanggama</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Waktu sanggama sekitar ovulasi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">3. Ultrasonografi (USG)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Untuk menilai :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Uterus : bentuk, ukuran, kelainan</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Adneksa : ovarium dan tuba</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">4. Histerosalpingografi (HSG)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Menilai </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Faktor tuba : lumen, mukosa, oklusi, perlengketan </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Faktor uterus : kelainan kongenital (Hipoplasia, septum, bikornus, Duplex), mioma, polip, adhesi intrauterin (sindroma asherman)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Dilakukan pada fase proliferasi : 3 hari setelah haid bersih dan sebelum perkiraan</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">ovulasi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Keterbatasan : tidak bisa menilai</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Kel. Dinding tuba : kaku, sklerotik</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Fimbria : Fimosis fimbria</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Perlengketan genitalia Int.</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Endometriosis</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Kista ovarium</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Patensi tuba dapat dinilai :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">HSG</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Hidrotubasi (Cairan)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Pertubasi (gas CO</span><sub><span class="Apple-style-span" style="font-size:medium;">2</span></sub><span class="Apple-style-span" style="font-size:medium;">)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">5. Laparoskopi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Gbran visualisasi genitalia interna scr menyulurh</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Menilai faktor :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Peritoneum/endometriosis</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Perlengketan genitalia Int</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Tuba : patensi, dinding, fimbria</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Uterus : mioma</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Ovulasi : Stigma pada ovarium dan korpus luteum</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Keterbatasan </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Tidak bisa menilai : Kelainan kavum uteri dan lumen tuba</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Bersifat invasif dan operatif</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><b><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">PENANGANAN</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Medika mentosa</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Tindakan operasi rekonstruksi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Rekayasa teknologi reproduksi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><b><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">MEDIKA MENTOSA</span></span></b><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Obat stimulasi ovarium (Induksi ovulasi)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo11;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Klomifen sitrat</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo12;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Symbol;"><span class="Apple-style-span" style="font-size:medium;">¨</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Meningkatkan pelepasan gonadotropin FSH & LH</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo12;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Symbol;"><span class="Apple-style-span" style="font-size:medium;">¨</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Diberikan pd hari ke-3 siklus haid</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo12;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Symbol;"><span class="Apple-style-span" style="font-size:medium;">¨</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">1 x 50mg selama 5 hari</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo12;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Symbol;"><span class="Apple-style-span" style="font-size:medium;">¨</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Ovulasi 5 - 10 hari setelah obat terakhir</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo12;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Symbol;"><span class="Apple-style-span" style="font-size:medium;">¨</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Dosis bisa ditingkatkan </span></span><span style=" ;font-family:'Monotype Sorts';"><span class="Apple-style-span" style="font-size:medium;">þ</span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> 150 - 200 mg/hari</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo12;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Symbol;"><span class="Apple-style-span" style="font-size:medium;">¨</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">3 - 4 siklus obat tdk ovulasi hCG 5000 - 10.000 IU</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Epimestrol</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Memicu pelepasan FSH dan LH</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Hari ke 5 - 14 siklus haid</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">5 - 10 mg/hari</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Bromokriptin</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Menghambat sintesis & sekresi prolaktin</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Indikasi : Kdr prolaktin tinggi (> 20 mg/ml) dan Galaktore</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Dosis sesuai kadar prolaktin : </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Oligomenore 1,25 mg/hari </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Ggn haid berat : 2 x 2,5 mg/hari</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Gonadotropin</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">HMG (Human Menopausal Gonadotropine)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">FSH & LH : 75 IU atau 150 IU</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Untuk memicu pertumbuhan folikel</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Dosis awal 75 - 150 IU/hari selama 5 hari dinilai hari ke 5 siklus haid</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">hCG </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">5000 IU atau 10.000 IU</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Untuk memicu ovulasi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Diameter folikel 17 - 18 mm dgn USG transvaginal</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Mahal, sangat beresiko :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Perlu persyaratan khusus</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Hanya diberikan pada rekayasa teknologi reproduksi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><i><span style=" ;font-family:Constantia;"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></i></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><i><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Catatan : </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></i></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Untuk pria diterapi => FSH </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> Testosteron</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">2. Terapi hormonal pd endometriosis</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Supresif ovarium shg terjadi atrofi kel. Endometriosis</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Danazol : </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Menekan sekresi FSH & LH</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Dosis 200 - 800 mg/hari, dosis dibagi 2x pemberian</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Progesteron</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Desidualisasi endometrium </span></span><span style=" ;font-family:'Monotype Sorts';"><span class="Apple-style-span" style="font-size:medium;">þ</span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> Atrofi jar. Endometritik</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Medroksi progesteron asetat 30 - 50 mg/hari</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">GnRH agonis </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Menekan sekresi FSH & LH</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Dosis 3,75 mg/IM/bulan</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Tidak boleh > 6 bulan : penurunan densitas tulang</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Constantia;"><br /></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><b><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">TINDAKAN OPERASI REKONSTRUKSI</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo11;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Koreksi : - Kel. Uterus</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> - Kel. Tuba : tuba plasti</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo11;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Miomektomi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo11;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Kistektomi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo11;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Salpingolisis</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo11;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Laparoskopi operatif + Terapi hormonal </span></span><span style=" ;font-family:'Monotype Sorts';"><span class="Apple-style-span" style="font-size:medium;">þ</span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> kasus endometriosis + infertilitas</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><b><i><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Catatan :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></i></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Tindakan operatif pada pria :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Rekanalisasi </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Operasi Varikokel</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Constantia;"><br /></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo13;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><b><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">REKAYASA TEKNOLOGI REPRODUKSI</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo11;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Metode lain tidak berhasil</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo11;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Inseminasi Intra Uterin (IIU)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Paling sederhana</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Sperma yg telah dipreparasi diinseminasi kedalam kavum uteri saat ovulasi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Syarat : tdk ada hambatan mekanik : kebuntuan tuba & Fc. Peritoneum/endometriosis</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Indikasi </span></span><span style=" ;font-family:'Monotype Sorts';"><span class="Apple-style-span" style="font-size:medium;">þ</span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;"> Infertilitas oleh karena faktor :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo14;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Serviks</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo14;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Gangguan ovulasi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo14;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Endometriosis ringan & </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo14;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Infertilitas Idiopatik</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Angka kehamilan 7 - 24 % siklus</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Fertilisasi Invitro (FIV)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Fertilisasi diluar tubuh dgn suasana mendekati alamiah</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Pilihan terakhir</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Syarat : </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Uterus & endometrium normal</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Ovarium mampu menghasilkan sel telur</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Mortilitas sperma min. 50.000/ml</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-19.45pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:medium;">—</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Angka kehamilan : 30 - 35 %</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><i><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Catatan :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></i></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Constantia;"><span class="Apple-style-span" style="font-size:medium;">Untuk pria ICSI</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Constantia;"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></p> <p class="MsoNormal"><span lang="IN"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></p>DEVIANAhttp://www.blogger.com/profile/01031644635327768252noreply@blogger.com0tag:blogger.com,1999:blog-6730807132725239761.post-66239877995270291542009-12-10T16:32:00.000-08:002009-12-11T08:40:17.353-08:00PRINSIP-PRINSIP PEMERIKSAAN GINEKOLOGI<div style="text-align: center;"><br /></div><div style="text-align: left;"><span class="Apple-style-span" style="color: rgb(0, 0, 153); font-weight: bold; ">ANAMNESIS</span></div><div><div><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:27.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-27.0pt;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style=" ;font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"></p><ul><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Identitas</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Keluhan utama</span></li><li><span class="Apple-style-span" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Keluhan lain yang menyertai keluhan utama</span></span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Riwayat haid : menarke, lama,</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Frekuensi, sifat, hpht, menopause</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Riwayat obstetrik : gravida, paritas, riwayat abortus (G P A)</span></li><li><span class="Apple-style-span" style=" ;font-family:'Book Antiqua';font-size:small;">Masalah payudara ?</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;"><span class="Apple-style-span" style=" ;font-family:'Book Antiqua';">Riwayat operasi ginekologi </span></span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;"><span class="Apple-style-span" style=" ;font-family:'Book Antiqua';">Riwayat menderita penyakit infeksi, riwayat infertil, pemakaian obat-obatan</span></span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;"><span class="Apple-style-span" style=" ;font-family:'Book Antiqua';"><span class="Apple-style-span" style=" ;font-family:Arial;">Riwayat seks : umur pertama kali melakukan hubungan seks, pola kehidupan seks</span></span></span></li><li><span class="Apple-style-span" style=" ;font-family:'Book Antiqua';font-size:small;"><span class="Apple-style-span" style=" ;font-family:Arial;">Riwayat kontrasepsi : pemakaian kontrasepsi, jenis kontrasepsi, lama penggunaan</span></span></li></ul><p></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-family:Arial;"><span class="Apple-style-span" style=" ;font-size:small;"><span class="Apple-style-span" style="color:#000099;">PEMERIKSAAN FISIK</span></span></span></b></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style=" font-weight: bold; font-family:Arial;font-size:small;">Prinsip :</span></p><ul><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Penderita terlebih dahulu disuruh</span><span><span class="Apple-style-span" style="font-size:small;"> </span></span><span class="Apple-style-span" style="font-size:small;">berkemih terlebih dahulu</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Beritahu tentang prosedur pemeriksaan yang akan dilakukan, cara pemeriksaan</span></li><li><span class="Apple-style-span" style="font-family:Arial;"><span class="Apple-style-span" style=" ;font-size:small;">Tanyakan apakah pasien mengerti dan setuju untuk dilakkukan pemeriksaan</span></span></li></ul><span class="Apple-style-span" style=" font-weight: bold; font-family:Arial;font-size:small;">Organ yang diperiksa :</span><br /><ul><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Payudara</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Abdomen</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Organ pelvik :</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Vulva</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Klitoris</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Kelenjar bartholin</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Skene</span></li></ul><p></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"><b><span class="Apple-style-span" style="color:#000099;">ALAT DAN BAHAN YANG DIPERLUKAN</span></b></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"></p><ul><li><span class="Apple-style-span" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Sarung tangan (Handschoen) disposible</span></span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Alat penjepit has</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Slide, spatula, untuk pemeriksaan pap smear</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Lubrikan</span></li><li><span class="Apple-style-span" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">kapas, kapas lidi/cyto brush</span></span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Asam asetat untuk membersihkan mukus</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Betadine</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Lugol iodine untuk Schiller test</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Tenakulum</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Sonde Uterirus</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Forsep untuk biopsi</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Endometrial curette or intrauterine lavage equipment</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Kateter metal untuk mengeluarkan urin</span></li><li><span class="Apple-style-span" style="font-family:Arial;"><span class="Apple-style-span" style=" ;font-size:small;">Alat dalam rahim (bagi yang ingin kontrasepsi ADR)</span></span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">kauter</span></li><li><span lang="IN" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Grave’s </span></span><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Spe</span></span><span lang="IN" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">c</span></span><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">ulum (spekulum cocor bebek) segala ukuran</span></span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;font-size:small;">Spekulum Sims</span></li></ul><p></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style=" ;font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style=" font-weight: bold; font-family:Arial;font-size:small;"> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEidukPunPVmeQJx4BXFuT-g9m1Crpzrd8TRud_Ho4-vNCRLcziZe7DCo2fAVHjqb8uvphxjONHIuoBSNkFxwAZBZTQbXOUseEWIq3EOsmQ6QVCQ790uoddorWEC6PzbpkM5_Uklcf64BUg-/s200/Picture2+(2).png" style="cursor:pointer; cursor:hand;width: 200px; height: 136px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5413771843548710082" /><span class="Apple-style-span" style=" font-weight: normal; font-family:Georgia, serif;"><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4GnhRm6HR48umOt1272124C64uTX6Z8yi8zpngBGhsK46MaINomFRhzqA7xIqXAfe_jUXHIlehEytW4Y6pK4AzZZ6awV4htmz1UaJlyVQPO0BW-bAzplK_naoDG80XOq0ADwhy0mdEASo/s200/Picture3.jpg" style="cursor:pointer; cursor:hand;width: 127px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5413771851542444274" /><span class="Apple-style-span" style=" ;font-size:-webkit-xxx-large;"><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhh32EmaHkVD-mu8y17fHdM3W0uWaX7RLyRCieiq8yUk0wEmLDOrfcMEapAjcpQBX-mt0UvJDNRjMsDU7aovMuGiMWwILZbI2iW_yoD4rXggFVKhprq5yIwfp_4x0dZM4ibDBUhN2ROEz1V/s200/Picture5+(2).jpg" style="cursor:pointer; cursor:hand;width: 107px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5413771865024114930" /><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjvXwQBAGGaysCsfTK9LbQnGH156BRujEsU9dBbQsrM0CKIqOZpQbFEOuk-Fd8j3aasEvvRaTpvV75-qSNfnR2RNSTURMZtwne_eCKfQRDpYUuZ4haQ0N7afUGj8rmdlOQ2VOrq4ctqSXhb/s200/Picture4.jpg" style="cursor:pointer; cursor:hand;width: 117px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5413771860712633330" /></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"> Spekulum Grave's Spekulum Sim's</p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"> </p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi0B1FZW_KhjUQ8GnMCXbP_E8PAJpBxCNMHCgJmj3cgvJ9_xREEzPKOrgerDOut9a8G29zblj5kTQJcyXiO3klx63g9Lu0uydQzdho3d1b_wemwHJtb-58I2LMzfCPwc63g3k_nVEt8zmfi/s200/Picture7.jpg" style="cursor:pointer; cursor:hand;width: 200px; height: 56px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5413771873122849730" /><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiilJb5-EKYd5XV54M9o7CHbUrE96Yht2BdxJIcD2GhyphenhyphenpIszz6H-nE4v97YUvz0Hn9PboGVYzlcXKXD4UBFZTTbsvZHe4RDe2j-agX6guOjBES5Y0HX_KgVVfE31n3B5xO4jGBdUkJ8-kKT/s200/Picture8+(2).jpg" style="cursor:pointer; cursor:hand;width: 200px; height: 96px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5413786366484801346" /></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;"> Sonde uterus Tenakulum</span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;"><b><span class="Apple-style-span" style=" ;font-size:medium;"><span class="Apple-style-span" style="color:#000099;">PEMERIKSAAN ABDOMEN</span></span></b></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"></p><ul><li><span class="Apple-style-span" style=" ;font-family:Arial;">Pasien berbaring posisi supinasi</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;">Relaks, menggunakan bantal kepala</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;">Usahakan agar abdomen tidak tegang</span></li><li><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Inspeksi abdomen : nilai apakah ada </span></span><st1:city><st1:place><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">massa</span></span></st1:place></st1:city><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">, pembesaran organ, asites,</span></span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Palpasi : 4 kuadran =></span><span><span class="Apple-style-span" style="font-size:small;"> </span></span><span class="Apple-style-span" style="font-size:small;">menurut arah jarum jam</span></span></li><li><st1:city><st1:place><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Massa</span></span></st1:place></st1:city><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"> : ukuran/besarnya, batas, permukaan, konsistensi</span></span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;">Ukuran dan bentuk hepar, limpa</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;">Perkusi : nyeri ketok ?</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;">Pasien : inspirasi/ekspirasi saat memeriksa hepar</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;">Auskultasi : bising usus</span></li></ul><p></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;"><br /></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;"> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLTyvZ20qtYqPX88QmQRLgprwc6Dh4s-2gZJCG1hmiE3AGGJiuhW2Dj-0k047w9GngZBXCcpsnTTNKakPGlvFNFh-nuhlWw9ixCN1S8Wac2CIJvGinpvj61bnFpV4-NGU0dnenH9GSjhSM/s200/Picture9.png" style="cursor:pointer; cursor:hand;width: 200px; height: 137px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5413786376478901666" /></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"><i> Pemeriksaan Abdomen</i></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;"><br /></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"><b>PEMERIKSAAN PELVIK</b></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"></p><ul><li><span class="Apple-style-span" style=" ;font-family:Arial;">Pasien posisi litotomi</span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;">Vulva, perineum : eritema, pigmentasi, tumor</span></li><li><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Palpasi </span></span><span style="font-family:"Monotype Sorts";mso-ascii-font-family: Arial;mso-hansi-font-family:Arial;mso-bidi-mso-ansi-language: EN-US;mso-char-type:symbol;mso-symbol-Monotype Sorts"font-family:";"><span style="font-family:";"><span class="Apple-style-span" style="font-size:small;">è</span></span></span><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"> mobilitas, konsistensi, nyeri ?</span></span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;">Ulkus : kultur atau biopsi</span></li><li><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Mons pubis</span><span><span class="Apple-style-span" style="font-size:small;"> </span></span></span><span style="font-family:"Monotype Sorts";mso-ascii-font-family:Arial;mso-hansi-font-family: Arial;mso-bidi-mso-ansi-language:EN-US;mso-char-type:symbol; mso-symbol-Monotype Sorts"font-family:";"><span style="font-family:";"><span class="Apple-style-span" style="font-size:small;">è</span></span></span><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"> palpasi</span></span></li></ul><p></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"><b>Inpeksi</b></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"></p><ul><li><span class="Apple-style-span" style=" ;font-family:Arial;">Buka labia : amati adanya lesi, kemerahan, pembengkakan, cauliflower (veneral wart)</span></li></ul><span class="Apple-style-span" style=" ;font-family:Arial;"> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhbKT9vs1aLfP7Z940f1Y0J3EOhmHZv48O63UciKETrm8DXHf75R-ct3iHwRO4JsYeITKHTjqbMfM6dc6FCEHO_mcyRTa2S4nAjc9sy26_u345BBZFF904HKalL7fLPS1meqbehlbhZv1ru/s200/Picture20.JPG" style="cursor:pointer; cursor:hand;width: 184px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5414008107391503874" /><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgFfgccrz7k66vmfA-bFxCHM8K8aMTFXeZbLHAW0KhTuKAtr9LLmcX-xCAJJLB45D4JSD2sznPqXL3RdguM5UIeg_ysbgFd_7ORRMKqaFbFSQphgkXf39Zb-BDX5NzGpmS21JwhVgVDKiN7/s200/Picture21.JPG" style="cursor:pointer; cursor:hand;width: 116px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5414008118039541282" /></span><br /><div><span class="Apple-style-span" style="font-family:Arial;"><br /></span></div><ul><li><span lang="IN" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Amati antara lipatan kulit </span></span><span lang="IN" style="font-family:Symbol;mso-ascii-font-family:Arial; mso-hansi-font-family:Arial;mso-bidi-mso-char-type:symbol; mso-symbol-font-family:Symbol;"><span style="font-family:Symbol;"><span class="Apple-style-span" style="font-size:small;">®</span></span></span><span lang="IN" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"> lesi herpes</span></span></li></ul><span class="Apple-style-span" style="font-family:Arial;"> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGrRVWoLSQ5TUy80x6XKbfkPfv2gR0odLKmQmzaZc7Sx-KUb-GpH23fSt_5GUDri8NRLqhyphenhyphena0S17NbHK5sPmqmlm_umX2aJSsGnmZ7Yc68MrqfpOZJueXVyoTO6zfrWiqGmPji46CJAHqO/s200/Picture13.png" style="cursor:pointer; cursor:hand;width: 176px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5413774711591001282" /><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgJFq_1ez9Sf0lL38tl4fLLnhZjkUUPL9jIeSX93f_tp6sIMteFrnplhguSTpAVbvpKJ4lqgbxjnqy8WG0WB7wLliyRGK-iR5-Rs08Sk8tl2B81M8vO1aqb6Dr9uz6lbkuMn8mo2OVQqLZw/s200/Picture16.png" style="cursor:pointer; cursor:hand;width: 158px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5413774713966529714" /></span><span class="Apple-style-span" style="font-family:Arial;"><br /></span><ul><li><span lang="IN" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Amati himen : kemerahan </span></span><span lang="IN" style="font-family:Symbol;mso-ascii-font-family:Arial; mso-hansi-font-family:Arial;mso-bidi-mso-char-type:symbol; mso-symbol-font-family:Symbol;"><span style="font-family:Symbol;"><span class="Apple-style-span" style="font-size:small;">®</span></span></span><span lang="IN" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"> vulvar vestibulitis</span></span></li></ul><span class="Apple-style-span" style="font-family:Arial;"><div><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjc-TRJjs1Oi4-UGMlYh22V0r2bA5yTecmHyPq10WSA7K8E9-Kzimur82qMrH3YfWfS8Z_5pK0Ag8-ga8FMDu8kkrTvpInC8G5WDdljszQEBISTgLVepLtQAlpyO1rsIz0jujd7uywCehX9/s200/Picture2+jp.JPG" style="cursor:pointer; cursor:hand;width: 182px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5414005930502287122" /><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjsT1PK2ObR9xabJhPQshA3yRp7z3yiOmt6Zrqs7z9wX5dRnpn1AAUZ886O7GEcdGgrTM5cjOEk4i8sdXUo__nI4MKCW_-ljiYoIqP_10VZCuxTWD7MOMcz8tSY9pD8nLEsSJB5_Bvig8HC/s200/Picture11.jpg" style="cursor:pointer; cursor:hand;width: 150px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5413774703669896338" /><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjPUWMwn0N1DSsWx8pGT4IvdYU5hHBlrhVfzSMT11qRAa7fmpI4vnlIsWJRQjTsubEzd9CTCOgtHf4gziLGVmZmZAE9IN3IGuIUYGNbvUQ75lT9-FbGHsgCkVCGDAa8mLwOC0rOy8ugXXCx/s200/Picture10.jpg" style="cursor:pointer; cursor:hand;width: 150px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5413786384005603618" /></div><br /></span><span class="Apple-style-span" style=" ;font-family:Arial;"><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span lang="IN" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"> Himen Himen imperforata</span></span></span></span></div><div><span class="Apple-style-span" style="font-family:Arial;"><br /></span></div><div><ul><li><span lang="IN" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Kelenjar </span></span><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">p<span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Arial;">eriurethral (Sk<span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Arial;">ene's glands).</span></span></span></span></span></span></li><li><span lang="IN" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Uretra : amati apakah ada cairan yang keluar </span></span><span lang="IN" style="font-family: Symbol;mso-ascii-font-family:Arial;mso-hansi-font-family:Arial;mso-bidi-mso-char-type:symbol;mso-symbol-font-family:Symbol;"><span style="font-family:Symbol;"><span class="Apple-style-span" style="font-size:small;">®</span></span></span><span lang="IN" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"> GO atau klamidia</span></span></li><li><span class="Apple-style-span" style=" ;font-family:Arial;">Palpasi labia majora atas : hernia labialis (melalui kanalis Nuck)</span></li><li><span lang="IN" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Palpasi labia majora bagian bawah dan tengah : bila ada massa </span></span><span lang="IN" style=" font-family:Symbol;mso-ascii-font-family:Arial;mso-hansi-font-family:Arial; mso-bidi-mso-char-type:symbol;mso-symbol-font-family:Symbol;"><span style="font-family:Symbol;"><span class="Apple-style-span" style="font-size:small;">®</span></span></span><span lang="IN" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"> </span></span></li></ul><span class="Apple-style-span" style=" ;font-family:Arial;"><span class="Apple-tab-span" style="white-space:pre"> </span>kista bartolini</span><br /><p></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;"> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhG40eAJLWMr3tzxNf4N_99Wq2TZXPqTcmledtIl6Y9xnsltAbzcG8ZjhdjKQ7DQpDP2KUJYS5hPbt7wge5X3fTSxED5zVKbb1Y27-UDsgeMcQF0FQDAYfVeMPAC_s3vV5W9Lu2cM2ZCtuV/s200/Picture22.jpg" style="cursor:pointer; cursor:hand;width: 200px; height: 150px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5414008122882546978" /></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;"><b><br /></b></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;"><b>Inspekulo </b>:</span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;">Memasang spekulum ke dalam vagina untuk meli<span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Arial;">hat kondisi <span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Arial;">vagina dan portio</span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;"> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi6TPO_cnKPDeJCyJ6YzNQL3Ine8ACN_QN1aLgLJlMM7SW0Ec-YWPxMvETVl55K9S3Rq2IRL29Z7u8Nud0bsuk-HRBA9Kigf9Uz82JaK5rL4WmYbSgOQzuYSlGqfKPx3SkCbMc7sGQYFHX0/s200/Picture24.JPG" style="cursor:pointer; cursor:hand;width: 200px; height: 136px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5414008126925154130" /><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRVCBhiEXGIcBU6xY6Y6SVO_cp9PGp1aKbtna249dWeRFt2miZl7LnRKOosMSjcK26cBBB8iGcWdve0zkDYdIFkpPDvEGreaEwCEMfq0S3L5sqw-TMXVL4eiUP5ql-xA_SLEZZ9yt1LX06/s200/Picture23.png" style="cursor:pointer; cursor:hand;width: 200px; height: 137px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5413774685790289266" /></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Pasang spekulum </span></span><span style="font-family:Symbol;mso-ascii-font-family: Arial;mso-hansi-font-family:Arial;mso-bidi-mso-ansi-language: EN-US;mso-char-type:symbol;mso-symbol-font-family:Symbol;"><span style="font-family:Symbol;"><span class="Apple-style-span" style="font-size:small;">®</span></span></span><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"> </span></span><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">pemeriksaan vagina dan serviks diam<span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">at<span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Arial;">i, jika ada lendir yang</span></span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style=" ;font-family:Arial;">mencurigakan<span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"> diperiksa </span></span><span style="font-family:Arial;"><span><span class="Apple-style-span" style="font-size:small;"> </span></span></span><span style=" font-family:Symbol;mso-ascii-font-family:Arial;mso-hansi-font-family:Arial; mso-bidi-mso-ansi-language:EN-US;mso-char-type:symbol; mso-symbol-font-family:Symbol;"><span style="font-family:Symbol;"><span class="Apple-style-span" style="font-size:small;">®</span></span></span><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"> </span></span><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">pap <span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Arial;">smear</span></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">I</span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;"> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiz3uZ_8Kynb8Nkue03cxxu2wH_U83ui-_We0D3Y9K2VfeB1ugDNvalb0wsEEgZmZLzTL848ipZM2jmU-RVdvBdnE8Oe0DTM6mPnSJqIfgIUoFrMoVCbAqmti8jfJ5sDKAcDKV39ZjnVlob/s200/Picture26.jpg" style="cursor:pointer; cursor:hand;width: 200px; height: 149px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5413995836335910914" /><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEieFQDEmQLULsLSUHEU6yxqx-czU6mZz4oDt05MJMj5Gzz5bnGfPs7QK-plz8ehE-SV-hlFgdVyno8xljh-nyI-9pZuOQwHnOntBHvLOxrr0V4Opo-IqHqxg3J4YNBJKnBqmIQEb5n7U_pu/s200/Picture27.jpg" style="cursor:pointer; cursor:hand;width: 200px; height: 170px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5414008127738599106" /></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;"><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjsd1_87byKakemXK5GIoX29S3GukgzNOc5OL1XaB1l8fj70XsuxamG4tAREy07I0WB-pIpPl7vi-_3933I3XpnTiE8ZTfxymQDgkbY30u6wuF_8mGqv3l4BBzZVv-J9TKjAeS9OXYe3P_E/s200/Picture28.jpg" style="cursor:pointer; cursor:hand;width: 196px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5414012227459544770" /></span></span></p><p class="MsoNormal" align="left" style="text-align: center;margin-bottom: 0.0001pt; text-indent: 0in; "><span class="Apple-style-span" style="font-family:Arial;"><br /></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; font-family:Arial;">PEMERIKSAAN BIMANUAL</span></p><ul><li><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Jari telunjuk dan jari tengah dimasukkan ke dalam vagina </span></span><span style="font-family:Symbol;mso-ascii-font-family:Arial; mso-hansi-font-family:Arial;mso-bidi-mso-ansi-language:EN-US; mso-char-type:symbol;mso-symbol-font-family:Symbol;"><span style="font-family:Symbol;"><span class="Apple-style-span" style="font-size:small;">®</span></span></span><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"> </span></span><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">di daerah forniks </span></span></li></ul><span class="Apple-style-span" style=" ;font-family:Arial;"><span class="Apple-tab-span" style="white-space:pre"> </span>posterior, tangan lain di luar, di bawah umbilikus</span><br /><ul><li><span class="Apple-style-span" style=" ;font-family:Arial;">Vagina, forniks dan serviks dipalpasi</span></li></ul><ul><li><span lang="IN" style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">N</span></span><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">ilai uterus : besar, ukuran, bentuk, posisi, konsistensi</span></span></li></ul><ul><li><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Adneksa kiri, kanan : pembesaran </span></span><span style="font-family:Symbol; mso-ascii-font-family:Arial;mso-hansi-font-family:Arial;mso-bidi-mso-ansi-language:EN-US;mso-char-type:symbol;mso-symbol-font-family:Symbol;"><span style="font-family:Symbol;"><span class="Apple-style-span" style="font-size:small;">®</span></span></span><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"> </span></span><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">besar, ukuran, bentuk, konsistensi, </span></span></li></ul><p></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"><span class="Apple-tab-span" style="white-space:pre"> </span>mobilitas, sensitivitas</span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;"><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiMu_mp5dqobg-Uqwb2p2mSk67upSpGbLa7FpCGX-bHmOwFkn7_LIqkiVB2hogmmnrjCv4lDOPYb7rCkpukBCdw_vA8J__OzoFHp9EaYzPBYZIaVO2OALgRWWPjW3VHebYkpms7Y-Yue68-/s200/Picture29.png" style="cursor:pointer; cursor:hand;width: 145px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5414008983080152210" /><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg8htDw3e4Q84K-BATdSZNuhC4quSQHvKo8QvPr9cpyhNu-TdzYKBod69sina9Z-UsFqDv3MMTi4ruNm5cde1Axj3q13M6AqmNAE8YXtdrClIOvC79Fy-30Y22qxVEP7OwQF3r_CaDg793q/s200/Picture30.jpg" style="cursor:pointer; cursor:hand;width: 200px; height: 166px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5414008994039280210" /><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdr3NGpN8128NafBj21UFbnemTsrQO_Wf4AFj276QM5lppEU98W865lj07Ca4gnf9VfPwJ_xAMT3dFgnOmbzXZu7OXA10Yq5eMDlJQfCaul8EQ5Bu2M-CgXNwi09B44vj_2SEjj_UWNf04/s200/Picture31.jpg" style="cursor:pointer; cursor:hand;width: 200px; height: 96px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5414008998601482226" /></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;"><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgPc1egjlk8osKl6BQAHJeQWLTi5vPbn8JAjiHSCzCjmURqtH35ufwyYKhUPSNcwHyZyVIPDSuY3iyKoC50yu5Ab_y5Ml71G9KjgyOcdtaIR88RN0qZNFMkzq5kkhhJr53KlIbu2MEOaTMu/s200/Picture32.jpg" style="cursor:pointer; cursor:hand;width: 170px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5414005454891250370" /></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style=" ;font-family:Arial;">Pemeriksaan rektal rutin pada wanita menopause</span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"><span class="Apple-tab-span" style="white-space:pre"> </span>Nilai : sfingter ani, mukosa usus, </span></span><st1:city><st1:place><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">massa</span></span></st1:place></st1:city><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;"> hemoroid</span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;"><br /></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;"><b>Hasil pemeriksaan : <span class="Apple-style-span" style="color:#000099;">NORMAL</span>, bila :</b></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;">Genitalia eksterna tampak normal</span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;">Tidak ditemukan pembesaran kelenjar bartolini ataupun skene</span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;">Tidak ada nyeri tekan pada uretra ataupun buli-buli</span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;">Vagina bersih, tidak ada lesi, ataupun cairan keputihan</span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Permukaan serviks halus, tidak ada lesi, dan bila dierakkan tidak nyeri</span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;">Ukuran, bentuk dan kontur uterus normal dan tidak nyeri</span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:small;">Tidak ditemukan pembesaran ataupun nyeri di daerah adneksa</span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;">Pada beberapa pasien jika ditemukan adanya massa pelvis, melakukan </span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;">pemeriksaan rektovaginal dapat membantu</span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;">Pemeriksaan rektovaginal dapat membantu untuk menilai ligamentum sakrouterina,</span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;">yang merupakan lokasi endometriosis yang paling sering</span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style=" ;font-family:Arial;">Pemeriksaa rektal : nilai apakah ada darah atau tidak.</span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Arial;"><br /></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;"><o:p><span class="Apple-style-span" style="font-size:small;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style=" ;font-family:Arial;">.</span></p><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmdi-Csrlv1G6KoZ_E7L52ott81rYoMB11FOS2emJSWMRUA-bVBLl7w-lCcf9Ssi6WfCjBfSrumU8Vxxr2nS48MrVspQhZNfjTCLycPXjsOTahg2XAMXBzpW8R9RYwjBkdOMPLr0A3O72w/s400/Picture33.jpg" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 255px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5414014170662419122" /> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;font-size:14.0pt;"><o:p> </o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Arial;font-size:14.0pt;"><o:p> </o:p></span></p> <p class="MsoNormal" style="margin-left:-17.85pt;text-indent:0in"><span lang="IN" style="font-size:14.0pt;"><o:p> </o:p></span></p></div></div>DEVIANAhttp://www.blogger.com/profile/01031644635327768252noreply@blogger.com3tag:blogger.com,1999:blog-6730807132725239761.post-89625430017706685692009-12-09T05:29:00.011-08:002009-12-09T06:19:30.466-08:00GANGGUAN HAID<div style="text-align: center;"><span class="Apple-style-span" style="font-size:7;"><span class="Apple-style-span" style="font-size:25px;"><span class="Apple-style-span" style="font-size:130%;"><span class="Apple-style-span" style="font-size:16px;"><br /></span></span></span></span></div> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";font-size:16.0pt;"><span style="mso-spacerun:yes"> </span><o:p></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span> </span><span class="Apple-style-span" style="font-size:medium;">Gangguan haid </span><span class="Apple-style-span" style="font-size:medium;">merupakan</span><span class="Apple-style-span" style="font-size:medium;"> perdarahan haid yang tidak normal dalam hal : </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>panjang siklus haid, lama haid, dan jumlah darah haid.</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Terjadinya haid melibatkan hipotalamus, hipofisis, ovarium dan endometrium.</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>(poros H-H-O-E)</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size:medium;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><b>Fisiologi haid normal</b></span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Kaidah-2 haid normal :</span></span></b></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-style-span" style="font-weight: normal; ">Berlangsung antara 25-35 hari atau 21-31 hari</span></span></span></b></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-style-span" style="font-weight: normal; ">Hormon estrogen dihasilkan oleh follikel & korpus luteum </span></span></span></b></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-style-span" style="font-weight: normal; ">Peningkatan <span class="Apple-style-span" style="font-family:Georgia, serif;"><span style=" font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size: medium;"> hormon estrogen pada pertengahan siklus menyebabkan terjadi </span></span></span></span></span></span></b></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-weight: normal; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-size: medium;"><span style=" font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"></span></span><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"> </span></span><span class="Apple-style-span" style="font-size: medium;">lonjakan Luteneizing Hormone (LH) dan memicu terjadi </span></span><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size: medium;">ovulasi</span></span></span></span></span></b></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-weight: normal; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size: medium;">Hormon progesteron dihasilkan oleh korpus luteum, yang hanya terbentuk bila terjadi</span></span></span></span></span></b></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-weight: normal; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"> </span></span><span class="Apple-style-span" style="font-size: medium;">ovulasi</span></span></span></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Umur korpus luteum ±10-14 hr, sehingga fase luteal/fase sekresi ±14 hr</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span>(hampir selalu tetap)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Fase folikulogenesis/Fase proliferasi variasi antara 7-21hr</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Ovulasi terjd 14 hr sebelum haid berikutnya dan korpus luteum terbtk ±16 jam </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>setelah ovulasi</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Haid terjadi 4 hr sesudah korpus luteum mati</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Haid yang teratur umumnya ovulatoar (terjadi ovulasi) , tidak teratur umumnya </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>anovulatoar (tidak terjadi ovulasi)</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size:medium;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size:medium;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style=" ;font-family:Papyrus;font-size:medium;"><b>Gambaran proses haid</b></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Jenis-jenis gangguan haid, dibedakan dalam :</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> </span></span>Kelainan panjang siklus (N=21-35hr):</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Polimenore (sering) </span></span><span style="font-family:"Century Gothic";mso-fareast-font-family: "Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning: 12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">→ <span class="Apple-style-span" style=" ;font-family:Papyrus;"><></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Oligomenore (jaran<span class="Apple-style-span" style="font-family:Georgia, serif;"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size: medium;">g) </span></span><span style="font-family:"Century Gothic";mso-fareast-font-family: "Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning: 12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size: medium;">→</span></span><span style=" font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size: medium;"> > 35 hr</span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Amenore (tidak haid) </span></span><span style="font-family:"Century Gothic";mso-fareast-font-family: "Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning: 12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">→</span></span><span style=" font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"> > 3 bln</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style=" font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Kelainan banyaknya haid (N=±80ml):</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Hipermenore (banyak) </span></span><span style="font-family:"Century Gothic";mso-fareast-font-family: "Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning: 12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">→</span></span><span style=" font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"> > 80ml</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Hipomenore (sedikit) </span></span><span style="font-family:"Century Gothic";mso-fareast-font-family: "Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning: 12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">→</span></span><span style=" font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"> <></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style=" font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Kelainan lama haid (N= 3-7hr):</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Menoragi (memanjang) >7 hari</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Brakimenore (memendek) <3></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Metroragi (haid diluar siklus normal)</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Perdarahan bercak</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Premenstrual spotting</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Postmenstrual spotting</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Perdarahan uterus disfungsional</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Gangguan lain berhubungan dengan haid :</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Metroragi (haid diluar siklus) </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Dismenore (nyeri bila haid)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Premenstrual tension (ketegangan haid)</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><b>Kelainan panjang siklus haid :</b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><b><br /></b></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-48.0pt;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">1.</span><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">Polimenore</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></b></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-48.0pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Definisi polimenore adalah panjang siklus haid kurang dari 21 hari (normal 21-35).</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-48.0pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">Keadaan polimenore bisanya terjadi pada siklus ovulatoar maupun pada siklus </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-48.0pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">anovulatoar.</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Kausa :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Arial;"><span><span class="Apple-style-span" style="font-size:medium;">-</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Anovulasi karena gangguan hormonal</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Arial;"><span><span class="Apple-style-span" style="font-size:medium;">-</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Insufisiensi korpus luteum (fase luteal memendek)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Arial;"><span><span class="Apple-style-span" style="font-size:medium;">-</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Fase folikuler memendek</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Penanganan :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Arial;"><span><span class="Apple-style-span" style="font-size:medium;">-</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Pada kausa anovulasi diberikan induksi ovulasi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Arial;"><span><span class="Apple-style-span" style=" ;font-size:medium;">-</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Pada insufisiensi korpus luteum diberikan progesteron pada hr 16-25</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Arial;"><span><span class="Apple-style-span" style="font-size:medium;">-</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Pada fase folikuler pendek diberikan estrogen pada hari 3-8</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-style-span" style="font-weight: bold; ">2. Oligomenore</span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">Definisi oligomenore adalah panjang siklus haid lebih dari 35 hari (normal 21-35 hari) </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">dan kurang dari 3 bulan. </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">Keadaan oligomenore umumnya adalah siklus ovulator sehingga fertilitas tidak </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">terganggu.</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Kausa :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Arial;"><span><span class="Apple-style-span" style="font-size:medium;">-</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Fase folikuler memanjang</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Arial;"><span><span class="Apple-style-span" style=" ;font-size:medium;">-</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Fase sekresi memanjang</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Penanganan :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Arial;"><span><span class="Apple-style-span" style="font-size:medium;">-</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Tidak diberikan pengobatan jika tipe perdarahan teratur</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Arial;"><span><span class="Apple-style-span" style="font-size:medium;">-</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Indukasi ovulasi diberikan jika tipe perdarahan memanjang</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-style-span" style="font-weight: bold; ">3. Amenore</span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-48.0pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Definisi : tidak haid lebih dari 3 bln berturut-turut.</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-48.0pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Amenore dapat dibagi dalam dua bentuk :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-48.0pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">-</span><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><b><span class="Apple-style-span" style="font-size:medium;">Amenore fisiologik :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></b></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-48.0pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">• Prapubertas / pasca menopause</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-48.0pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">• Hamil, laktasi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-48.0pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">-</span><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><b><span class="Apple-style-span" style="font-size:medium;">Amenore patologik :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></b></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-48.0pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">• Amenore primer</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-48.0pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">• Amenore sekunder</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-48.0pt;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-48.0pt;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style=" ;font-family:Papyrus;font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><b> </b></span>Penyebab: Gangguan hipotalamus, hipofisis, ovarium (folikel), uterus (endometrium) </span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-48.0pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><b><span class="Apple-style-span" style="font-weight: normal; "><span class="Apple-tab-span" style="white-space:pre"> </span>dan vagina</span></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-48.0pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><b><span class="Apple-style-span" style="font-weight: normal; "><span class="Apple-tab-span" style="white-space:pre"> </span>Diagnosis ditegakkan berdasarkan </span></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style=" ;font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Anamnesis</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Pemeriksaan fisis</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Pemeriksaan ginekologik</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Pemeriksaan penunjang</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo9;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size:medium;"><br /></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Anamnesis :</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Usia menars,pertbhan badan</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Verdana;"><span><span class="Apple-style-span" style="font-size:medium;">◦</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Rwyt stress berat,penyk berat,obat-2 penenang,obat-2 penurun ber</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:48.95pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style=" ;font-size:medium;">at badan</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Pem.fisis :BB,TB, pertbhan sex sekund. </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Pem.ginekologis : pem.genitalia interna/externa</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Pem.penunjang :foto Ro,kampimeter, T3/T4,pem.kromosom</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><b><br /></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><b><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Penanganan Amenore</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">Tergtg kausa : organik atau fungsional ? </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> </span></span>Organik ditangani</span><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">sesuai kel.organik</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> </span></span>Fungsional : konseling, obat</span><sup><span class="Apple-style-span" style="font-size:medium;">2 </span></sup><span class="Apple-style-span" style="font-size:medium;">psikofarmak, subsitusi & pemberian hormon secara </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>siklik, induksi ovulasi<br /><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Uji hormonal </span></span><span style="font-family:"Century Gothic"; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">→</span></span><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"> untuk menilai kausa</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><b>Kelainan jumlah perdarahan haid</b><br /><br /><b>1. Hipermenore</b><br /></span><span><span class="Apple-style-span" style="font-size:medium;"></span></span><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Definisi : perdarahan haid yang </span><span class="Apple-style-span" style="font-size:medium;">jumlahnya banyak (>80 ml atau ganti<br /></span><span><span class="Apple-style-span" style="font-size:medium;"></span></span><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>pembalut >5 kali/hari)<span class="Apple-tab-span" style="white-space:pre"> </span></span><span class="Apple-style-span" style="font-size:medium;">Kausa :-Kel.organik (tumor,infeksi)<br /></span><span><span class="Apple-style-span" style="font-size:medium;"></span></span><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>-Kel.darah (penyk.darah)<br /></span><span><span class="Apple-style-span" style="font-size:medium;"></span></span><span><span class="Apple-style-span" style="font-size:medium;"></span></span><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>-Kel.fungsional (endokrin)<br /></span><span><span class="Apple-style-span" style="font-size:medium;"></span></span><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Penanganan : Sesuai kausa</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span><b>2. Hipomenore</b></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Definisi </span><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">: Perdrhan haid yg jumlahnya sdkt (<40ml></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span class="Apple-style-span" style=" ;font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Penanganan :</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:";"><span><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">tdk perlu terapi jika siklus ovulatoar</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:";"><span><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">subsitusi hormon E&P bila perlu</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:";"><span><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">induksi ovulasi jika siklus anovulatoar & ingin anak.</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Times New Roman';"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><b>Kelainan lamanya haid</b></span></span><span lang="IN" style="font-family:Papyrus;mso-fareast-font-family: "Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning: 12.0ptfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> </span></span><b>Menoragi</b> : Haid berlangsung >7hr dgn jumlah darah yang banyak</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span><span class="Apple-style-span" style="font-size:medium;"></span></span><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Kausa & penanganan = dg hipermenore</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> </span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"></span></span><b><span class="Apple-tab-span" style="white-space:pre"> </span>Brakimenore </b>: Haid berlangsung <3hr><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span><span class="Apple-style-span" style="font-size:medium;"></span></span><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Kausa & penanganan sama dengan hipomenore</span></span><span lang="IN" style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0ptfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size:medium;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><b>Perdarahan bercak</b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><b><span class="Apple-style-span" style="font-weight: normal; "><span class="Apple-tab-span" style="white-space:pre"><b> </b></span>Premenstrual spotting : Perdrhan yg terjd 3-4 hr sblm haid berupa bercak darah</span></b></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span><span class="Apple-style-span" style="font-size:medium;"></span></span><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Kausa : kelainan endokrin (estrogen rendah</span></span><span style=" font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">) prahaid &</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style=" font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span> kel.organik (polip,erosi porsio)</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span><span class="Apple-style-span" style="font-size:medium;"></span></span><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Penanganan :sesuai penyebab</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> </span></span>Postmenstrual spotting : Perdrhan bercak yg terjd spi 7 hr stlh haid normal</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span><span class="Apple-style-span" style="font-size:medium;"></span></span><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Kausa : ggn reepitelisasi endometrium & inf.</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:";"><span><span class="Apple-style-span" style="font-size:medium;"></span></span><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Penanganan : kuret dan antibiotik</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> </span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"></span></span><b>Perdarahan Uterus Disfungsional (PUD)</b></span></span><span lang="IN" style="font-family: Papyrus;mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0ptfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning:12.0ptfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> </span></span>Definisi : Perdarahan uterus abnormal (lama,banyak & panjangnya) </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning:12.0ptfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>yg terjadi semata-mata krn ggn fungsional mekanisme kerja poros </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning:12.0ptfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>H-H-O-E, tanpa adanya kelainan organik organ reproduksi </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning:12.0ptfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>dan penggunaan kontrasepsi atau pengobatan hormonal.</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Klasifikasi PUD </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>berdasarkan usia : PUD perimenars,reproduksi, perimenopause</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>berdasarkan kausa : PUD ovulatorik, anovulat, folikel persisten</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>berdasarkan kadar Hb : ringan,sedang,berat</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>berdasarkan gej.klinik : akut dan kronik</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size:medium;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;">Penyebab </span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> </span></span>kelainan fungsi salah 1 tempat dari sistem sumbu H-H-O</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> </span></span>Patofisiologi : pengaruh hormon E & P tdk bekerja sesuai fase-2 yg sehrsnya</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> </span></span>Gambaran klinik: pengeluaran darah dr uterus yg menyalahi ciri-2 haid normal</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> </span></span>Diagnosis : anamnesis,pem.fisis,pem ginek, pem penunjang,penentuan ovulasi</span></span><span lang="IN" style="font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS"; mso-bidi-Arial Unicode MS";mso-font-kerning:12.0ptfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> </span></span>Penanganan PUD</span></span><span lang="IN" style="font-family:Papyrus;mso-fareast-font-family: "Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning: 12.0ptfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span>Perbaiki KU, bl anemia </span></span><span style="font-family:"Century Gothic";mso-fareast-font-family: "Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning: 12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">→</span></span><span style=" font-family:Papyrus;mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">transfusi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span>Hentikan perdarahan :E, P, E+P, CC, anti fibrinolitik & </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>anti prostaglandin, kuret (bila perlu), ablasi endometrium dg laser atau HT</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span>Cegah agar PUD tdk berulang</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span>Kembalikan fungsi hormon reproduksi</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span>Hilangkan ancaman keganasa</span></span><span style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"; mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span class="Apple-style-span" style="font-size:medium;">n (tergantung hasil patologi anatomi pasca kuret)</span><o:p></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Papyrus;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfXGIDlPOqsX55iwU78fiBLyqSYf1oVqEGIPgpkYCsIsgUXlAWRrnNiSDfdKIhyphenhyphenhrYpjpg36l2maQGTF2k2KLjXMiKg_I5InefMxS2FPyjsrz-Hmb7sfj0AIOlKqEAbgK90teWsDmqSiHw/s400/Picture1.jpg" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 349px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5413230431732718914" /> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.4in;margin-bottom:.0001pt;text-align:left; text-indent:-20.15pt;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Papyrus;mso-fareast-font-family: "Arial Unicode MS";mso-bidi-Arial Unicode MS";mso-font-kerning: 12.0ptfont-family:";font-size:16.0pt;"><o:p> </o:p></span></p> <p class="MsoNormal"><span lang="IN" style="font-family:Papyrus; mso-fareast-font-family:"Arial Unicode MS";mso-bidi-Arial Unicode MS"font-family:";font-size:16.0pt;"><o:p> </o:p></span></p>DEVIANAhttp://www.blogger.com/profile/01031644635327768252noreply@blogger.com2tag:blogger.com,1999:blog-6730807132725239761.post-26030852471076853662009-12-08T07:26:00.000-08:002009-12-08T08:13:55.256-08:00PROM<div style="text-align: center;"><br /></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><br /></div><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">PREMATURE RUPTURE OF THE MEMBRANES</span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="text-align: center;margin-top: 0in; margin-right: 0in; margin-left: 23pt; margin-bottom: 0.0001pt; text-indent: -23pt; "><span class="Apple-style-span" style="font-size: large;"><br /></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Premature rupture of membranes </span></span><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">(PROM) </span></span><span lang="IN" style="font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span><span class="Apple-style-span" style="font-size: large;"> </span></span><span class="Apple-style-span" style="font-size: large;">: </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-tab-span" style="white-space:pre"> </span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-tab-span" style="white-space:pre"></span><span class="Apple-tab-span" style="white-space:pre"> </span>rupture of the fetal </span><span class="Apple-style-span" style="font-family: Georgia, serif; "><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">membranes before the onset of</span></span><span style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> </span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">labor.</span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Preterm PRO</span><span class="Apple-style-span" style="font-family: Georgia, serif; "><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">M (PPROM) : </span></span><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">membrane rupture before 37 weeks’ gestation</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Preterm PRO</span><span class="Apple-style-span" style="font-family: Georgia, serif; "><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">M : </span></span><span style="font-family:Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span><span class="Apple-style-span" style="font-size: large;"> </span></span><span class="Apple-style-span" style="font-size: large;">3 </span></span><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">% </span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">of pregnanci<span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">es</span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> </span></span><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">and leads to one third of preterm births.</span></span></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size: large;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">I</span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">ncreases the ris</span><span class="Apple-style-span" style="font-family: Georgia, serif; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">k of prematurity and leads</span></span><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> </span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">to a number of other perinatal and </span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-family: Georgia, serif; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">n<span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">eonatal</span></span><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> </span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">complication<span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">s, including a 1 to 2 </span></span><span lang="IN" style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">% <span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">risk</span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> of fetal death</span></span></span></span></span></span></span></span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="text-align: center;margin-top: 0in; margin-right: 0in; margin-left: 23pt; margin-bottom: 0.0001pt; text-indent: -23pt; "><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><b><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Risk Factors</span></span></b><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><b><br /></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Black patients are <span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">at increased</span></span><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> </span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">risk compared w<span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">ith </span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span><span class="Apple-style-span" style="font-size: large;"> </span></span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">white</span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> </span><span lang="IN"><span class="Apple-style-span" style="font-size: large;">p</span></span></span><span style="font-family:Rockwell;mso-bidi-mso-font-kerning: 12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">atients.</span></span></span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">L</span></span><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">ower socioeconomic</span></span><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> </span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">status</span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Smokers</span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">S</span></span><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">exually</span></span><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> </span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">transmitted infections</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">P</span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">revious</span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> </span></span><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">preterm delivery</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">U</span></span><span lang="DA" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0pt; mso-ansi-language:DAfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">terine distension</span></span><span lang="IN" style="font-family:Rockwell;mso-bidi-mso-font-kerning: 12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Cerclage</span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">A</span></span><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">mniocentesis.</span></span><span lang="IN" style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><b>DIAGNOSIS</b></span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size: large;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">His</span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">tory taking :</span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">A sudden gush of fluid with continued leakage</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">C</span></span><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">ontracti</span></span><span lang="IN" style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">on ?</span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">B</span></span><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">leeding vaginally</span></span><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> ?</span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">H</span></span><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">as had inter<span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">course</span></span><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> </span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">recently</span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> ?</span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">F</span></span><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">ever.</span></span><span lang="IN" style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size: large;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">It is important to <span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">verify the</span></span><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> </span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">patient’s estimated due date </span></span><span style="font-family:Symbol;mso-ascii-font-family:Rockwell; mso-hansi-font-family:Rockwell;mso-bidi-font-family:Rockwell;mso-font-kerning: 12.0pt;mso-ansi-language:EN-US;mso-char-type:symbol;mso-symbol-font-family:Symbol;"><span style="font-family:Symbol;"><span class="Apple-style-span" style="font-size: large;">®</span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> treatment.</span></span></span></span></span></p><p class="MsoNormal" align="left" style="text-align: center;margin-top: 0in; margin-right: 0in; margin-left: 23pt; margin-bottom: 0.0001pt; text-indent: -23pt; "><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">P</span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">hysical examination :</span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">P</span></span><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">erform a speculum examination</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-15.1pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:"Wingdings 2";mso-fareast-font-family:"Wingdings 2";mso-bidi-Wingdings 2";mso-font-kerning:12.0ptfont-family:";"><span><span class="Apple-style-span" style="font-size: large;">–</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">evaluate if any cervical dilation and effacement</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-15.1pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-15.1pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style=" font-family:"Wingdings 2";mso-fareast-font-family:"Wingdings 2";mso-bidi-Wingdings 2";mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:";"><span><span class="Apple-style-span" style="font-size: large;">–</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Evidence of fluid pooling in the vagina, or leaking</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-15.1pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-15.1pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:"Wingdings 2";mso-fareast-font-family:"Wingdings 2";mso-bidi-Wingdings 2";mso-font-kerning:12.0ptfont-family:";"><span><span class="Apple-style-span" style="font-size: large;">–</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">from the cervical os when the<span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">patient coughs or</span></span><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> </span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">when fundal pressure </span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-15.1pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-15.1pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-tab-span" style="white-space:pre"> </span>is applied</span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-15.1pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Nitrazine paper <span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">& </span></span><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">fern</span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> test : 90 %</span></span></span></span></span></p><p class="MsoNormal" align="left" style="text-align: center;margin-top: 0in; margin-right: 0in; margin-left: 0.7in; margin-bottom: 0.0001pt; text-indent: -0.25in; "><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="color:#FF0000;">A</span></span></span><span style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0pt; mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="color:#FF0000;">void performing a digital cervical examination</span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;color:#FF0000;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">increase morbidity and mortalitas</span></span></p><p class="MsoNormal" align="left" style="text-align: center;margin-top: 0in; margin-right: 0in; margin-left: 0.7in; margin-bottom: 0.0001pt; text-indent: -0.25in; "><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><o:p><span class="Apple-style-span" style="font-size: large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Laboratory</span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Culture</span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Vaginal swab</span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="text-align: center;margin-top: 0in; margin-right: 0in; margin-left: 0.7in; margin-bottom: 0.0001pt; text-indent: -0.25in; "><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">USG</span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Amniotic fluid index (AFI)</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Gestational age</span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Number of fetus</span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Placental location</span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Estimated fetal weight</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Anomaly</span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size: large;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Amniocentesis : indigo carmine</span></span></p><p class="MsoNormal" align="left" style="text-align: center;margin-top: 0in; margin-right: 0in; margin-left: 23pt; margin-bottom: 0.0001pt; text-indent: -23pt; "><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><o:p><span class="Apple-style-span" style="font-size: large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><b>MANAGEMENT</b></span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="text-align: center;margin-top: 0in; margin-right: 0in; margin-left: 23pt; margin-bottom: 0.0001pt; text-indent: -23pt; "><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Corticosteroid</span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">E</span></span><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">ffective </span></span><span lang="IN" style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">to </span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">decr<span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">eas</span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">e</span></span><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> perinatal morbidity and mortality. </span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span><span class="Apple-style-span" style="font-size: large;"></span></span><span class="Apple-style-span" style="font-size: large;"><span class="Apple-tab-span" style="white-space:pre"> </span>(RDS, I<span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">VH, NEC </span></span><span lang="IN" style="font-family:Symbol;mso-ascii-font-family:Rockwell; mso-hansi-font-family:Rockwell;mso-bidi-font-family:Rockwell;mso-font-kerning: 12.0pt;mso-char-type:symbol;mso-symbol-font-family:Symbol;"><span style="font-family:Symbol;"><span class="Apple-style-span" style="font-size: large;">¯)</span></span></span></span></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Betamethasone im </span></span><span style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0pt; mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">12 mg every 24 hours for two days or</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-tab-span" style="white-space:pre"> </span>dexamethasone </span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">im <span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">6 mg every12 hours for two days.</span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">The National In<span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">stitutes of</span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> </span></span><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Health <span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span lang="IN" style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><</span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> 30 to 32 weeks’ gestation, </span></span></span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-tab-span" style="white-space:pre"> </span>assuming feta<span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">l viability</span></span><span style="font-family:Rockwell; mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> </span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">and no evidence of intra-amniotic infection.</span></span></span></span></span></span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Administration of corticosteroids after 34 week<span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">s’ gestation</span></span><span style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> </span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">is not </span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-tab-span" style="white-space:pre"> </span>recommended unless there is evidence of feta<span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">l</span></span><span lang="IN" style=" font-family:Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> lung immaturity</span></span></span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="text-align: center;margin-top: 0in; margin-right: 0in; margin-left: 0.7in; margin-bottom: 0.0001pt; text-indent: -0.25in; "><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Antibiotic</span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.7in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-style-span" style="font-size: large;">•</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">T</span></span><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">he National <span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Institute of</span></span><span style="font-family: Rockwell;mso-bidi-mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> </span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Child Health and Human Development</span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-15.1pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:"Wingdings 2";mso-fareast-font-family:"Wingdings 2";mso-bidi-Wingdings 2";mso-font-kerning:12.0ptfont-family:";"><span><span class="Apple-style-span" style="font-size: large;">–</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">2 grams of <span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">ampicillin and</span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"> 250 m<span class="Apple-style-span" style="font-size: 16px; "><span class="Apple-style-span" style="font-size: large;">g of</span><span><span class="Apple-style-span" style="font-size: large;"> </span></span><span class="Apple-style-span" style="font-size: large;">erythromycin IV/6 hr for </span></span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-15.1pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="font-size: 16px; "><span class="Apple-style-span" style="font-size: large;"><span class="Apple-tab-span" style="white-space:pre"> </span>48 hours, followed by <span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span lang="IN" style=" font-family:"Wingdings 2";mso-fareast-font-family:"Wingdings 2";mso-bidi-Wingdings 2";mso-font-kerning:12.0ptfont-family:";"><span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: large;"> </span></span></span></span><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">250 mg amoxicillin +</span></span></span></span></span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-15.1pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="font-size: 16px; "><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-tab-span" style="white-space:pre"> </span>333 mg of erythromycin/8<span class="Apple-style-span" style="font-size: 16px; "><span class="Apple-style-span" style="font-size: large;">hr </span></span></span></span></span></span></span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-15.1pt;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="font-size: 16px; "><span class="Apple-style-span" style="font-size: large;"><span class="Apple-tab-span" style="white-space:pre"> </span>for 5 – 7</span><span><span class="Apple-style-span" style="font-size: large;"> </span></span><span class="Apple-style-span" style="font-size: large;">days.</span></span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="text-align: center;margin-top: 0in; margin-right: 0in; margin-left: 1.1in; margin-bottom: 0.0001pt; text-indent: -0.2in; "><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;">Tocolytic</span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></p><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgrE28FjY6bOPClx1L4NCVij7crVJR_NLJEQ7OuFxolLa_rUkNWDYP0NbjvlMr0v8uOq6eS-O4vZ3vrQNGtlIXUONw4N_ZnvTvFzMJEv9f4aQq6dhytAzvDRR2emWYogsLhLSoInpC7ALgT/s400/prom.png" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 400px; height: 369px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5412890553702996562" /><p class="MsoNormal" align="left" style="text-align: center;margin-top: 0in; margin-right: 0in; margin-left: 23pt; margin-bottom: 0.0001pt; text-indent: -23pt; "><span class="Apple-style-span" style="font-family:Rockwell;"><span class="Apple-style-span"><span class="Apple-style-span" style="font-size: large;"><br /></span></span></span></p><div style="text-align: center;"><span class="Apple-style-span" style="font-size: large;"><br /></span></div><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-xeAc7axGUUcU3lcs2K1QjE670zb503pjpTnLfY0sSSjvLspXIqkR5yVS6gnlhTklZhFDzyhjwpq-VUlem-84EcgopgWxUdkzoU8YcX0kyU-Nu429igY1M1_9pP9CRRU8fgirfL53k49t/s320/pr2.png" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 221px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5412888911373936274" /> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:23.0pt;margin-bottom:.0001pt;text-align:left; text-indent:-23.0pt;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Rockwell;mso-bidi- mso-font-kerning:12.0ptfont-family:Rockwell;font-size:32.0pt;"><o:p> </o:p></span></p> <p class="MsoNormal"><span lang="IN"><o:p> </o:p></span></p>DEVIANAhttp://www.blogger.com/profile/01031644635327768252noreply@blogger.com0tag:blogger.com,1999:blog-6730807132725239761.post-62974216570305027192009-12-08T07:10:00.000-08:002009-12-08T07:23:35.473-08:00PRINSIP-PRINSIP PEMBEDAHAN DI OBGYNPRINSIP-PRINSIP PEMBEDAHAN <br /><br /><br />Keputusan operasi : setelah diagnosis ditegakkan melalui pemeriksaan fisik, <div><span class="Apple-tab-span" style="white-space:pre"> </span>pemeriksaan <span class="Apple-tab-span" style="white-space:pre"> </span>laboratorium, pemeriksaan roetngen<br /><br />Perlu diperhatikan keadaan mental penderita<br /><br /><span style="font-weight:bold;">Pembedahan elektif</span> : operator menentukan waktu pembedahan, </div><div><span class="Apple-tab-span" style="white-space:pre"> </span>setelah semua pemeriksaan lengkap dan kondisi pasien memungkinkan<div><br /><b>Pembedahan darurat</b> (emergency) : melakukan tindakan operasi sesegera </div><div><span class="Apple-tab-span" style="white-space:pre"> </span>mungkin, karena <span class="Apple-tab-span" style="white-space:pre"> </span>bila ditunda akan membahayakan penderita<br /><br /></div><div><b>Pembedahan paliatif</b> : bertujuan untuk mengurangi penderitaan pasien, </div><div><span class="Apple-tab-span" style="white-space:pre"> </span>tidak untuk <span class="Apple-tab-span" style="white-space:pre"> </span>menyembuhkan<br /><br /></div><div><b>Pembedahan percobaan</b> : dilakukan untuk mendapat kepastian tentang </div><div><span class="Apple-tab-span" style="white-space:pre"> </span>jenis penyakit<br /><br /></div><div><b>Indikasi pembedahan ginekologi</b><br /><span class="Apple-tab-span" style="white-space:pre"> </span>• Keperluan diagnostik : biopsi, kerokan, laparoskopi<br /><span class="Apple-tab-span" style="white-space:pre"> </span>• Tindakan untuk mengangkat tumor jinak atau ganas<br /><span class="Apple-tab-span" style="white-space:pre"> </span>• Tindakan untuk mengoreksi kelainan bawaan, atau kelainan akibat operasi<br /><span class="Apple-tab-span" style="white-space:pre"> </span>• Persiapan Pembedahan<br /><span class="Apple-tab-span" style="white-space:pre"> </span>• Pemeriksaan yang teliti untuk menegakkan diagnosis<br /><span class="Apple-tab-span" style="white-space:pre"> </span>• Nilai keadaan penderita<br /><span class="Apple-tab-span" style="white-space:pre"> </span>• Jika terdapat penyakit lain, sebaiknya disembuhkan terlebih dahulu, </div><div><span class="Apple-tab-span" style="white-space:pre"> </span>untuk mengurangi risiko operasi<br /><span class="Apple-tab-span" style="white-space:pre"> </span>• Jika operasi darurat : pemeriksaan yang esensial perlu dilakukan<br /><br /><b>Persiapan pasien :</b></div><div><br /></div><div>Malam sebelum operasi : makanan yang mudah dicerna<br /><br /></div><div>6 jam sebelum operasi, pasien dianjurkan puasa</div><div><br /></div><div>Dapat diberikan obat penenang<br /><br /></div><div>Pagi hari penderita di klisma<br /><br /></div><div>Obat pramedikasi : diatur oleh dokter anestesi<br /><br />Kandung kencing dikosongkan/pasang kateter<br /><br /></div><div>Operasi vagina : vagina dibersihakan<br /><br /></div><div>Operasi histerektomi : dilakukan toilet vagina yaitu pencucian vagina, </div><div><br /></div><div><span class="Apple-tab-span" style="white-space:pre"> </span>pengolesan antiseptik, tampon<br /><br /></div><div><br /></div><div><b>Penanganan masa pasca pembedahan</b><br /><br /></div><div>• Perubahan pada tubuh pasca operasi :</div><div><br /><span class="Apple-tab-span" style="white-space:pre"> </span> Kehilangan darah dan air yang menyebabkan berkurangnya volume </div><div><span class="Apple-tab-span" style="white-space:pre"> </span>cairan dalam sirkulasi. Karena hemokonsentrasi dan vaskonstriksi </div><div><span class="Apple-tab-span" style="white-space:pre"> </span>tekanan darah dipertahankan, dan dengan mengalir cairan dari ruang </div><div><span class="Apple-tab-span" style="white-space:pre"> </span>ekstraseluler, volume kemudian pulih kembali. </div><div><span class="Apple-tab-span" style="white-space:pre"> </span>Perlu pemantauan tanda vital<br /><br /></div><div><span class="Apple-tab-span" style="white-space:pre"> </span> Diuresis pascaoperasi agak berkurang. Pengukuran volume urin mutlak </div><div><span class="Apple-tab-span" style="white-space:pre"> </span>diperlukan, karena oligouri merupakan tanda shock mengancam<br /><br />• Saat operasi terjadi penghancuran protein jaringan, sehingga ekskresi kalsium </div><div><br /></div><div><span class="Apple-tab-span" style="white-space:pre"> </span>meningkat, pengeluaran natrium dan klorida menurun</div><div><br />• Setelah operasi : penderita perlu dipantau sampai sadar</div><div><br />• Perhatikan jalan nafas</div><div><br />• Setelah bebes efek bius : nyeri, berikan anti nyeri<br /><br />• Pantau pemberian cairan terutama melalui infus. <b>Hitung balance cairan</b></div><div><br />• Jangan terjadi dehidrasi atuapun kelebihan cairan (edema paru)</div><div><br />• Pasca operasi, pasien biasanya mual. Tidak boleh makan dan minum, </div><div><br /></div><div><span class="Apple-tab-span" style="white-space:pre"> </span>tunggu flatus (terutama pasien dengan anestesi general)</div><div><br /></div><div>• Setelah sadar dari pembiusan dan telah dapat bergerak, pasien dapat tidur miring</div><div><br /></div><div><span class="Apple-tab-span" style="white-space:pre"> </span> (merubah posisi tidur)</div><div><br />• Buka jahitan hari 7 - 10 </div><div> <br /><b>Komplikasi pasca operasi</b></div><div><b><br /><span class="Apple-style-span" style="font-weight: normal; ">• Syok</span></b></div><div><br /></div><div>• Perdarahan<br /><br /></div><div>• Gangguan saluran kencing : retensi urin<br /><br /></div><div>• Infeksi jalan kencing<br /><br /></div><div>• Distensi perut : hati-hati terjadi dilatasi lambung, ileus paralitik. </div><div><br /></div><div><span class="Apple-tab-span" style="white-space:pre"> </span>Makanan peros dihentikan, masukkan sonde lambung, dan pemberian <span class="Apple-tab-span" style="white-space:pre"> </span></div><div><br /></div><div><span class="Apple-tab-span" style="white-space:pre"></span><span class="Apple-tab-span" style="white-space:pre"> </span>makanan perenteral<br /><br />• Ileus paralitik umumnya timbul 48 – 72 jam pasca operasi, </div><div><br /></div><div><span class="Apple-tab-span" style="white-space:pre"> </span>tidak terdapat gerakan usus, perut tidak terlalu nyeri</div><div><br />• Ileus obstruktif : 5 – 7 hari pasca operasi, gerakan usus lebih keras, </div><div><br /></div><div><span class="Apple-tab-span" style="white-space:pre"> </span>disertai rasa mules yang keras dan berulang</div><div><br />• Infeksi</div><div><br />• Terbukanya luka operasi dan eviserasi</div><div><br />• tromboflebitis<br /><br /></div></div>DEVIANAhttp://www.blogger.com/profile/01031644635327768252noreply@blogger.com0tag:blogger.com,1999:blog-6730807132725239761.post-24578528380113378212009-12-08T06:04:00.000-08:002009-12-08T06:47:09.072-08:00KEHAMILAN LEWAT WAKTU<p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN"><span class="Apple-style-span" style="font-family:georgia;"><b><span class="Apple-style-span" style="font-size:x-large;"><span class="Apple-style-span" style="color:#000099;">Definisi</span></span></b></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN"><span class="Apple-style-span" style="font-family:georgia;"><b><span class="Apple-style-span" style="font-size:x-large;"><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-family: Georgia, serif; font-size: medium; font-weight: normal; font-style: italic; "><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-style: normal;"> </span></span><b>Post term = post date = prolonged = postmatur</b></span></span></span></b></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.45in;margin-bottom:.0001pt;text-align:left; text-indent:-27.0pt;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">WHO : kehamilan yang berlangsung lebih dari 294 hari atau lebih </span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span></span><span class="Apple-style-span" style="font-size:large;">sejak hari pertama haid terakhir dengan asumsi siklus haid 28 hari</span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"></span></span><span class="Apple-style-span" style="font-size:large;">Postmatur : sindroma klinik dengan gambaran :</span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="color:#CC9933;"><span class="Apple-style-span" style="font-size:large;">Stadium I : kulit kering, pecah2</span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="color:#CC9933;"><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span class="Apple-style-span" style="color:#CC9933;"><span class="Apple-style-span" style="font-size:large;">Stadium II : meconium staining, asfiksia</span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="color:#CC9933;"><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span class="Apple-style-span" style="color:#CC9933;"><span class="Apple-style-span" style="font-size:large;">Stadium III : distress pernapasan, kejang, kematian janin</span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:35.8pt;mso-layout-grid-align:none;text-autospace: none"><span class="Apple-style-span" style="font-family:'Arial Unicode MS';"><span class="Apple-style-span" style="font-size:large;"> </span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="white-space: pre;">
<br /></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">Neilson : rutin USG pada awal kehamilan menurunkan<span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">insiden induksi </span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>persalinan pada kehamilan lewat waktu<span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">(OR 0.61, 95%CI 0.52 – 0.72)</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:'Arial Unicode MS';color:#000099;"><b>
<br /></b></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:'Arial Unicode MS';"><b><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="font-size: x-large;">Etiologi</span></span></b><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="font-size:large;">?</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span> </span></span><span class="Apple-style-span" style="font-size:large;">Anensefal, defisiensi suphatase plasenta</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="font-size:large;">Cenderung berulang</span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span>ú</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;">Riwayat post term 1 x : RR 2.2</span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span>ú</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;">Riwayat post term 2 x : RR 3.2</span></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="font-size:large;">Kadar fibronektin rendah pada uk 39 mgg</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="font-size:large;">CRH</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.45in;margin-bottom:.0001pt;text-align:left; text-indent:-27.0pt;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:'Arial Unicode MS';color:#000099;"><b>
<br /></b></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:'Arial Unicode MS';"><o:p><b><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="font-size: x-large;">Risiko</span></span></b></o:p></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:'Arial Unicode MS';"><o:p><b><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="font-size: x-large;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-family: Georgia, serif; font-size: 16px; font-weight: normal; "><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:'Arial Unicode MS';color:#000099;"><span class="Apple-style-span" style="font-size: x-large;"><b> </b></span></span></span>Kematian bayi post term lebih tinggi dibandingkan lahir</span></span></span></b></o:p></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="font-size:large;">pada usia kehamilan 37- 41 minggu</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Mempengaruhi berat badan janin</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Ensefalopati (OR 2.7, 95% CI 1.6 – 4.8)</span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Cerebral palsy</span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Meconium stained </span></span><span lang="IN" style=" font-family:Symbol;mso-ascii-font-family:"Arial Unicode MS";mso-fareast-font-family: "Arial Unicode MS";mso-hansi-font-family:"Arial Unicode MS";mso-bidi-font-family: "Arial Unicode MS";mso-font-kerning:12.0pt;mso-char-type:symbol;mso-symbol-font-family:Symbol;"><span style="font-family:Symbol;"><span class="Apple-style-span" style="font-size:large;">®</span></span></span><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"> meconium aspiration syndrom</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Komplikasi persalinan : distosia bahu, trauma obstetrik</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:'Arial Unicode MS';"><span class="Apple-style-span" style="font-size:large;">
<br /></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:'Arial Unicode MS';"><b><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="font-size: x-large;">Penanganan </span></span></b><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#FF6600;"><b>Induksi sebelum</b></span></span><span><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#FF6600;"><b> </b></span></span></span><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#FF6600;"><b>40 minggu</b></span></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Menurunkan risiko meconium staining<span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">(OR 0.50 95%</span><span><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">CI 0.31 – 1.03)</span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#FF6600;"><b>Induksi setelah 41 minggu</b></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Systematic review :</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Induksi vs expectant management </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="font-size:large;">Menurunkan kematian perinatal (OR 0.23, 95% CI 0.06 – 0.90)</span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Meconium stained (OR 0.37, 95%CI 0.63 – 0.83)</span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Aspirasi meconium ()R 0.82, 95% CI 0.49 – 1.37)</span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Neonatal jaundice (OR 3.39, 95% CI 1.42 – 8.09)</span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Menurunkan risiko SC (OR 0.86, CI 0.76 – 0.98)</span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:'Arial Unicode MS';"><span class="Apple-style-span" style="font-size:large;">
<br /></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:'Arial Unicode MS';"><b><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="font-size: x-large;">Pemeriksaan kesejahteraan janin</span></span></b><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;">USG untuk mengukur volume air ketuban</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Crowley : 3 cm untuk 1 area</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Fischer : 2.7 cm</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Fischer :</span><span><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">volume 1 area lebih baik dari pada AFI</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">Profil biofisik</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">KTG</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">Fetal movement counting</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:'Arial Unicode MS';color:#000099;"><b>
<br /></b></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:'Arial Unicode MS';"><b><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="font-size: x-large;">Kesimpulan</span></span></b><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;">Penanganan yang paling efektif</span><span><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">: saat pemeriksaan</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>USG : menetukan taksiran persalinan ,</span><span><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">volume air ketuban, </span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span></span><i><span class="Apple-style-span" style="font-size:large;">Abdominal Circumference</span></i><span class="Apple-style-span" style="font-size:large;"> (lingkar perut janin) untuk</span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span></span><span class="Apple-style-span" style="font-size:large;">singkirkan pertumbuhan janin terhambat (berat janin rendah)</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Pemeriksaan bimanual : menentukan keadaan serviks</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:'Arial Unicode MS';"><span class="Apple-style-span" style="font-size:large;">
<br /></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:'Arial Unicode MS';"><b><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="font-size: x-large;">Konseling</span></span></b><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><b><span class="Apple-style-span" style="color:#FF6600;">Bila menunda persalinan </span></b>:</span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">Monitordengan KTG/hari</span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">USG untuk tentukan <i>Amniotic Fluid</i> <i>poo</i>l setiap 3 hari, </span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span></span><span class="Apple-style-span" style="font-size:large;">bila yang max 2.7 cm </span></span><span lang="IN" style="font-family:Symbol;mso-ascii-font-family:"Arial Unicode MS"; mso-fareast-font-family:"Arial Unicode MS";mso-hansi-font-family:"Arial Unicode MS"; mso-bidi-font-family:"Arial Unicode MS";mso-font-kerning:12.0pt;mso-char-type: symbol;mso-symbol-font-family:Symbol;"><span style="font-family:Symbol;"><span class="Apple-style-span" style="font-size:large;">®</span></span></span><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"> terminasi kehamilan</span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="color:#000099;"><b>
<br /></b></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="font-size: x-large;">Pengelolaan persalinan</span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span"><span class="Apple-style-span"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#FF6600;"><b>Terminasi bila uk 41 minggu</b></span></span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Tentukan Bishop score</span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span></span><span class="Apple-style-span" style="font-size:large;">Score > 5 : induksi. </span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="font-size:large;">Taksiran Berat Janin > 4000 gr : SC</span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span>Pantau dengan KTG dan kehadiran dr spesialis anak, </span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span></span><span class="Apple-style-span" style="font-size:large;">terutama bila </span><i><span class="Apple-style-span" style="font-size:large;">meconium stained</span></i></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><i><span class="Apple-style-span" style="font-style: normal; "><span class="Apple-tab-span" style="white-space:pre"><i><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></i></span></span></i></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><i><span class="Apple-style-span" style="font-style: normal; "><span class="Apple-tab-span" style="white-space:pre"><i><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"></span><span class="Apple-tab-span" style="white-space:pre"> </span> </span></span></i></span><span class="Apple-style-span" style="font-size:large;">Score <></span></i></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><i><span class="Apple-style-span" style="font-style: normal; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="font-size:large;">Nilai NST (KTG), volume air ketuban (AFI) </span></span><span lang="IN" style="font-family: Symbol;mso-ascii-font-family:"Arial Unicode MS";mso-fareast-font-family:"Arial Unicode MS"; mso-hansi-font-family:"Arial Unicode MS";mso-bidi-font-family:"Arial Unicode MS"; mso-font-kerning:12.0pt;mso-char-type:symbol;mso-symbol-font-family:Symbol;"><span style="font-family:Symbol;"><span class="Apple-style-span" style="font-size:large;">®</span></span></span><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span></i></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><i><span class="Apple-style-span" style="font-style: normal; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span></span><span class="Apple-style-span" style="font-size:large;">normal : lanjutkan kehamilan</span></span></span></span></i></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><i><span class="Apple-style-span" style="font-style: normal; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="font-size:large;">oligohidramnion , NST deseleasi variabel :</span></span></span></span></i></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><i><span class="Apple-style-span" style="font-style: normal; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="font-size:large;"> induksi</span></span></span></span></i></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><i><span class="Apple-style-span" style="font-style: normal; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="font-size:large;">AFI normal, NST non reaktif, CST</span></span></span></span></i></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><i><span class="Apple-style-span" style="font-style: normal; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="font-size:large;">Positif : lahirkan</span></span></span></span></i></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><i><span class="Apple-style-span" style="font-style: normal; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="font-size:large;">Negatif : konservatif, ulangi 3 hari </span></span></span></span></i></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none">
<br /></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><i><span class="Apple-style-span" style="font-style: normal; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;">Persalinan</span><span><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">pada uk 42 minggu dengan USG</span><span><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">dan KTG abnormal :</span><span><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span></span></i></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><i><span class="Apple-style-span" style="font-style: normal; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>SC , dihubungkan dengan morbiditas janin.</span></span></span></span></i></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none">
<br /></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><i><span class="Apple-style-span" style="font-style: normal; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;">Induksi pada postterm terutama bila terdapat meconium staining,</span></span></span></span></span></span></i></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-bottom:0in;margin-bottom:.0001pt; text-align:left;text-indent:0in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><i><span class="Apple-style-span" style="font-style: normal; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:";"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span></span><span class="Apple-style-span" style="font-size:large;">oligohidramnion</span><span><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" font-family:Symbol;mso-ascii-font-family:"Arial Unicode MS";mso-fareast-font-family: "Arial Unicode MS";mso-hansi-font-family:"Arial Unicode MS";mso-bidi-font-family: "Arial Unicode MS";mso-font-kerning:12.0pt;mso-char-type:symbol;mso-symbol-font-family:Symbol;"><span style="font-family:Symbol;"><span class="Apple-style-span" style="font-size:large;">®</span></span></span><span lang="IN" style="font-family:";"><span class="Apple-style-span" style="font-size:large;"> monitor denyut jantung janin, amnioinfusion</span></span></span></span></span></span></i></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.45in;margin-bottom:.0001pt;text-align:left; text-indent:-27.0pt;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="Arial Unicode MS";mso-font-kerning: 12.0ptfont-family:";font-size:14.0pt;"><o:p> </o:p></span></p> <p class="MsoNormal"><span lang="IN" style="Arial Unicode MS"font-family:";font-size:14.0pt;"><o:p> </o:p></span></p>DEVIANAhttp://www.blogger.com/profile/01031644635327768252noreply@blogger.com0tag:blogger.com,1999:blog-6730807132725239761.post-6064077917695033392009-12-07T09:13:00.010-08:002009-12-07T10:02:46.633-08:00MEDICAL DISORDER DURING PREGNANCY<p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b>ANEMIA</b></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">In normal pregnancy :</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-family: Georgia, serif; font-size: -webkit-xxx-large; "><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-size: medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Hemoglobin levels is falled </span></span></span><span lang="IN" style="font-family:Symbol;"><span class="Apple-style-span" style="font-size: medium;">®</span></span><span lang="IN" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;"> not associated with iron or</span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Corbel;"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:Corbel;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"> </span></span><span class="Apple-style-span" style="font-size: medium;">folate deficiency</span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Corbel;"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:Corbel;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"> </span></span><span class="Apple-style-span" style="font-size: medium;">Caused by : expansion in plasma volume is greater than </span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Corbel;"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:Corbel;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"> </span></span><span class="Apple-style-span" style="font-size: medium;">the increase in red cell mass</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span><i>haemodilution</i></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><i><br /></i></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> Haemodilution :</span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Hemoglobin concentration, hematocrit & red cell count is falled</span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Mean corpuscular volume (MCV) or </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>mean corpuscular haemoglobin concentration (MCHC)</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span> <span class="Apple-tab-span" style="white-space:pre"> </span>no change</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Pregnancy causes 2 – 3 fold increase in the requirment for iron</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>& 10 -20 fold increase in folate requirement</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>This is to meet the demands of the expanding red cell mass</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>and the fetus and placenta</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span><b><span class="Apple-style-span" style="color:#3333FF;">The Centers for Disease Control and Prevention (CDC) : </span></b></span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><b><span class="Apple-style-span" style="color:#3333FF;"> </span></b></span><b><span class="Apple-style-span" style="color:#3333FF;">anemia during pregnancy Hb <></span></b></span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#006600;"> </span></span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;color:#006600;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span><b>Etiologi</b></span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"><b><span class="Apple-style-span" style="font-weight: normal; "><span class="Apple-tab-span" style="white-space:pre"><b> </b></span>Acquired</span></b></span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Iron-deficiency anemia</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Anemia caused by acute blood loss</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Anemia of inflammation or malignancy (chronic disease)</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Megaloblastic anemia</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Acquired hemolityc anemia</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Aplastic or hypoplastic anemia</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Hereditary</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Thalassemias</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Sickle-cell hemoglobinopathies</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Other hemoglobinopathies</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Hereditary hemolityc anemias</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#CC0000;"><b>IRON-DEFICIENCY ANEMIA</b></span></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b><span class="Apple-style-span" style="color:#3366FF;">Two most common causes anemia during pregnancy :</span></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><b><span class="Apple-style-span" style="color:#3366FF;"> </span></b></span><b><span class="Apple-style-span" style="color:#3366FF;">iron deficiency & acute blood loss</span></b></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"><b><span class="Apple-style-span" style="color:#3366FF;"> </span></b></span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;color:#993399;"><span class="Apple-style-span" style="font-size:large;"><b><br /></b></span></span></p> <p class="MsoNormal" align="center" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:center; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="center" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:center; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><i><b>excessive blood loss with its concomitant loss of hemoglobin iron </b></i></span></span></p><p class="MsoNormal" align="center" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:center; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><i><b>& </b></i></span></span></p><p class="MsoNormal" align="center" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:center; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><i><b>exhaustion of iron stores </b></i></span><span class="Apple-style-span" style="font-size:large;"><i><b><o:p></o:p></b></i></span></span></p> <p class="MsoNormal" align="center" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:center; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><i><b>in pregnancy </b></i></span><span class="Apple-style-span" style="font-size:large;"><i><b><o:p></o:p></b></i></span></span></p> <p class="MsoNormal" align="center" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:center; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><i><b>can be cause of iron-deficiency anemia </b></i></span><span class="Apple-style-span" style="font-size:large;"><i><b><o:p></o:p></b></i></span></span></p> <p class="MsoNormal" align="center" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:center; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><i><b>in the next pregnancy</b></i></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:large;">Anemia in pregnancy may present with :</span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Tiredness</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Lethargy</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Dyspnoe</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Dizziness</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Fainting</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:'Wingdings 2';"> </span></span><b><span class="Apple-style-span" style="color:#3333FF;">Iron stores depleted </span></b></span></span><span lang="IN" style=" ;font-family:Symbol;"><span class="Apple-style-span" style="font-size:large;"><b><span class="Apple-style-span" style="color:#3333FF;">®</span></b></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b><span class="Apple-style-span" style="color:#3333FF;"> metabolic effects </span></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><b><span class="Apple-style-span" style="color:#3333FF;"> </span></b></span><b><span class="Apple-style-span" style="color:#3333FF;">influence muscle & neurotransmitter activity, </span></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><b><span class="Apple-style-span" style="color:#3333FF;"> </span></b></span><b><span class="Apple-style-span" style="color:#3333FF;">gastrointestinal absorption and epithelial changes</span></b></span><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#33CCFF;"><b><o:p></o:p></b></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#33CCFF;"><b> </b></span></span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""> </span></span><span lang="IN" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">Is common because many women enter pregnancy with </span></span></span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:Corbel;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"> </span></span><span class="Apple-style-span" style="font-size: medium;">depleted iron stores</span></span></span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Menstrual loss</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Inadequate diet</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Previous pregnancy (particularly with </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>an interval of less than a year between</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>delivery and conception)</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#CC0000;"><b>Iron deficiency anemia is associated with</b></span></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">preterm birth</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">low birthweight </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">increased blood loss at delivery</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b>Diagnosis</b></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Routine haematological investigation </span></span><span lang="IN" style=" ;font-family:Symbol;"><span class="Apple-style-span" style="font-size:large;">®</span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> first visit, 28 & 36 weeks</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Hb</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Hematocrit</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Red blood cell</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Peripheral blood smear</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Serum iron concentration</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Ferritin</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b>Treatment</b></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Ferrous sulfate, Ferrous fumarat or Ferrous gluconate : </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>200 mg (for 3 month)</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>response therapy : elevated reticulocyte count</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Transfussions or red blood cells or</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span> whole blood if severely anemic woman</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span>(hematocrit <><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#990000;"><b>ANEMIA FROM ACUTE BLOOD LOSS</b></span></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Massive acute hemorrhage :</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>immediate treatment to restore & maintain perfusion of </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>vital organ, such as the kidney</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Blood replaced does not completely repair the hemoglobin deficit </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>created by hemorrhage </span></span><span lang="IN" style=" ;font-family:Symbol;"><span class="Apple-style-span" style="font-size:large;">®</span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> should be treated with iron</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b><span class="Apple-style-span" style="color:#CC0000;">MEGALOBLASTIC ANEMIA</span></b></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Almost caused by folic acid deficiency</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Usually is found in women who do not consume </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>fresh green leafe vegetables, legumes, or animal protein</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b>Treatment</b> : </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">folic acid 1 mg/daily</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">A nutritious diet</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">iron</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#3333FF;"><b>Folate dificiency is associated with neural tube defects</b></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#3333FF;"><b> </b></span></span></span><span lang="IN" style=" ;font-family:Symbol;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#3333FF;"><b>®</b></span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#3333FF;"><b> CDC & ACOG recommended pregnant women consume </b></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="color:#3333FF;"><b> </b></span></span><span class="Apple-style-span" style="color:#3333FF;"><b>at least 0,4 mg folic acid daily</b></span></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Hb > 7 gr%, condition is stable, can ambulate without </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>adverse symptoms </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>iron therapy at least 3 mont is the best treatment </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>rather than blood transfussion</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Additional folic acid is given to :</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Multifetal pregnancy</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Hemolytic anemia</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Crohn disease</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Alcoholism</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Inflamatory skin disorder</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Women who previously have had infants with neural tube defects : </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>folic acid 4 mg/daily, is given prior to and through early pregnancy :</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span>Lower reccurence rate</span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">Megaloblastic anemia caused by vitamin B12 deficiency during pregnancy is rare</span></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Total or partial gastric resection</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Chron disease</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Ileal resection</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Bacterial overgrowth in the small bowel</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b><span class="Apple-style-span" style="color:#990000;">GESTATIONAL DIABETES</span></b></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Is defined as carbohydrate intolerance of variable severity </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>with onset of first recognition during pregnancy</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Develops as a consequence of the increased insulin resistance </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>of pregnancy and resolves postpartum</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Associated with excessive fetal growth (macrosomia) </span></span><span lang="IN" style=" ;font-family:Symbol;"><span class="Apple-style-span" style="font-size:large;">®</span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> birth trauma</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Gestational diabetes with elevated fasting glucosa </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>has been associated with unexplained stillbirth</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Adverse maternal effect :</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Hypertension</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Cesarean delivery</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Macrosomia</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Birthweigh > 4000 g</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Birth trauma </span></span><span lang="IN" style=" ;font-family:Symbol;"><span class="Apple-style-span" style="font-size:large;">®</span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> shoulder dystocia</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Macrosomia infants of diabetic mother are </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>anthropometrically different from other </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>large for age infants, specifically there is </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>excessive fat deposition on the shoulder and the trunk</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Maternal hyperglycemia : fetal hyperinsulinemia & stimulates </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>excessive somatic growth</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Neonatal hyperinsulinemia may provoke hypoglycemia</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b>Screening</b></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">ACOG (2001) :</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> Performed screening between 24 and 28 weeks in those </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>women not known to have glucose intolerance earlier in pregnancy </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-size: medium; "><span class="Apple-tab-span" style="white-space:pre"> </span>Using a 50-g oral glucose challenge test</span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Wingdings;"> </span></span>> 140 mg/dL are then tested with a diagnostic </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span>100 g oral glucose tolerance test</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b>Management</b></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Diet </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">The goal :</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">To provide the necessary nutrients for mother and fetus</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">To control glucose level</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">To prevent starvation ketosis</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">The American Diabetes Association (2000) : </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> 30 kcal/kg/day. (</span></span><st1:stockticker><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">BMI</span></span></st1:stockticker><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> > 30 kg/m</span><sup><span class="Apple-style-span" style="font-size:large;">2</span></sup><span class="Apple-style-span" style="font-size:large;"> : more restriction)</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Exercise</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Appropriate exercise : use the upper-body muscle or </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>place little mechanical stress on the trunk region </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Upper body cardiovascular training may result in </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>lower glucose level and reduce the insulin therapy</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Insulin : if fasting hyperglycemia > 105 mg/dL persists </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>despite diet therapy</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Oral Hypoglycemic Agent : not recommended</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b><span class="Apple-style-span" style="color:#CC0000;">HEART DISEASE IN PREGNANCY</span></b></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Hemodynamic changes during pregnancy </span></span><span lang="IN" style=" ;font-family:Symbol;"><span class="Apple-style-span" style="font-size:large;">®</span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> harmful for heart disease </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">During pregnancy :</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Oxygen consumption increased </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Increased cardiac output </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Increased circulating blood volume</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Increased heart rate </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Increase stroke volume</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b><br /></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b>Diagnosis</b></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Clinical indicator of Heart Disease during pregnancy</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Symptoms</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Progressive dispnea or othopnea</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Nocturnal cough</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Hemoptysis</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Syncope</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Chest pain</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Clinical findings</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Cyanosis</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Clubbing of fingers</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Persistent neck vein distention</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Systolic murmur grade 3/6 or grater</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Diastolic murmur</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Cardiomegaly</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Persistent arrhytmia</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Persistent split second sound</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Criteria for pulmonary hypertension</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Diagnostic studies</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Most studies are noninvasive & can be conducted safely in pregnancy</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Electocardiography</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Echocardiography</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Chest-X Ray</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Clinical classification</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">New York Heart Association Classification (NYHA)</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Class I : Uncompromised – no limited of physical activity. </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>No symptoms or cardiac insufficiency, nor or </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>they experience anginal pain</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Class II : Slight limitation of physical activity. </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>These women are comfortable at rest, but </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>if ordinary physical activity is undertaken, discomfort resulta </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>in form of excessive fatique, palpitation, dyspnea or anginal pain</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Class III : Marked limitation of physical activity. These women are comfortable at rest, but less than ordianary activity causes discomfort by excessive fatique. Palpitation, dyspnea or anginal pain</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Class IV : Severely compromised-inability to perform </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>any physical activity without discomfort. </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Symptoms of cardiac insuficiency or angina may develop </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>even at rest, and if any physical activity is undertaken, </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>discomfort increased</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b>Management </b></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Classes I and II</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Special attention should be directed toward both prevention </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>and early recognition of heart failure</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">First warning : nocturnal cough</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Increasing dyspnea, hemoptysis, progressive edema and tachycardia</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Infection has proved to be an important factor in </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>precipitating cardiac failur. Avoid contact with person </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>who have respiratory infections, including common cold</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Cigarette smoking is prohibited </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Labor and delivery</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Vaginal delivery unless there are obstetrical indication for </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>cesarean delivery</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Cardiovascular decompensation during labor manifest as </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>pulmonary odema, hypoxia, hypotension </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">During labor : </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:95.75pt;margin-bottom:.0001pt;text-align:left; text-indent:-.2in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">mother kept in a semirecumbent position with lateral tilt. </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:95.75pt;margin-bottom:.0001pt;text-align:left; text-indent:-.2in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Vital sign should be taken frequently between contraction.</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:95.75pt;margin-bottom:.0001pt;text-align:left; text-indent:-.2in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Increased pulse rate above 100 perminute or respiratory <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:95.75pt;margin-bottom:.0001pt;text-align:left; text-indent:-.2in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"></span><span class="Apple-tab-span" style="white-space:pre"> </span>above 24 associated with dyspnea </span></span><span lang="IN" style=" ;font-family:Symbol;"><span class="Apple-style-span" style="font-size:large;">®</span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:95.75pt;margin-bottom:.0001pt;text-align:left; text-indent:-.2in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>impending ventricular failure</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Delivery itself not improve maternal condition</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Classes III and IV</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Early pregnancy : termination</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">If pregnancy continued : prolonged hospitalization or bed rest</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Most cases : Vaginal delivery is preferred , cesarean delivery </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>is limited to obstetrical indication</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal"><span lang="IN"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p>DEVIANAhttp://www.blogger.com/profile/01031644635327768252noreply@blogger.com0tag:blogger.com,1999:blog-6730807132725239761.post-52469965870272173722009-12-07T06:21:00.000-08:002009-12-07T09:02:09.789-08:00DIAGNOSIS PRENATAL<div style="text-align: left;"><span class="Apple-style-span" style=" color: rgb(255, 153, 0); font-weight: bold; font-family:Perpetua;"><span class="Apple-style-span" style="font-size:x-large;">PENDAHULUAN</span></span></div> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><br /></span></p><p class="MsoNormal" align="left" style="text-align: left;margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-indent: -0.3in; "><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-tab-span" style="white-space:pre"></span></span></span><span style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span><span class="Apple-style-span" style="font-size:large;">Angka kematian perinatal di Indonesia </span></span><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; font-family:Georgia, serif;"><span style="font-family:'Times New Roman';"><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;">±</span></span></b></span><span style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;"> 40-50/1000 kelahiran hidup</span></span></b></span></span></span></b></span></p><p class="MsoNormal" align="left" style="text-align: left;margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-indent: -0.3in; "><span style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; font-family:Georgia, serif;"><span style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;"></span><span class="Apple-style-span"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Periode perinatal : dari umur kehamilan 28 minggu- 1minggu post partum</span></span></span></b></span></span></span></b></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><b><span class="Apple-style-span" style="color:#3333FF;"> </span></b></span><b><span class="Apple-style-span" style="color:#3333FF;">Kematian perinatal dapat diturunkan bila :</span></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><b><span class="Apple-style-span" style="color:#FF0000;"><span class="Apple-style-span" style="font-size:large;">Kualitas:</span></span></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><b><span class="Apple-style-span" style="color:#FF0000;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-family: Georgia, serif; font-weight: normal; "><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;">As</span></span><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;">uhan antenatal yang memenuhi syarat.</span></span></b></span></span></span></span></b></span></span></p><p class="MsoNormal" align="left" style="text-align: justify;margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-indent: -0.3in; "><span style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); "><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;">A</span></span></span><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;">suhan persalinan yang aman dan bersih</span></span></span></span></span></b></span></p><span lang="IN" style=" ;font-family:'Wingdings 2';"><div style="text-align: justify;"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;">Kesehatan maternal baik</span></span></b></span></span></div></span><p></p><p class="MsoNormal" align="left" style="text-align: justify;margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-indent: -0.3in; "><span class="Apple-style-span" style="font-family:Perpetua;color:#3333FF;"><span class="Apple-style-span" style="font-size:large;"><b><br /></b></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Perpetua;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="text-align: left;margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-indent: -0.3in; "><span class="Apple-style-span" style=" color: rgb(255, 153, 0); font-family:Perpetua;"><b><span class="Apple-style-span" style="font-size:x-large;">T</span></b><b><span class="Apple-style-span" style="font-size:x-large;">UJUAN DIAGNOSTIK PRENATAL</span></b></span></p><p class="MsoNormal" align="left" style="text-align: left;margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-indent: -0.3in; "></p><ul><li><span class="Apple-style-span" style="font-family: Perpetua; color: rgb(51, 51, 255); font-weight: bold; ">Apakah janin dapat meneruskan kehidupan intra uterin dengan aman? </span></li><li><span class="Apple-style-span" style="font-family: Perpetua; color: rgb(51, 51, 255); font-weight: bold; ">Apakah janin memerlukan perawatan dan resusitasi intra uterin? </span></li><li><span class="Apple-style-span" style="font-family: Perpetua; color: rgb(51, 51, 255); font-weight: bold; ">Kehidupan janin intra uterin terancam dan perlu segera dilahirkan</span></li></ul><p></p> <p class="MsoNormal" align="left" style="text-align: left;margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-indent: -0.3in; "><span style="font-family:Perpetua;"><o:p><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;"> </span></span></b></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><o:p><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;"> </span></span></b></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="text-align: left;margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-indent: -0.3in; "><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""> </span></span><span lang="IN" style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#FF9900;"><span class="Apple-style-span" style="font-size:x-large;">Cara pemantauan janin :</span></span></b><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-family:'Wingdings 2';color:#000000;"><span class="Apple-style-span" style="font-weight: normal; white-space: pre;"> </span></span>Klinis</span></span></b><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></b></span></p><p class="MsoNormal" align="left" style="text-align: justify;margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-indent: -0.3in; "><span style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:'Wingdings 2';"> </span></span>Biokimiawi</span></span></b><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></b></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-family:'Wingdings 2';"><span class="Apple-style-span" style="white-space: pre;"> </span></span>Genetik</span></span></b><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></b></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:'Wingdings 2';"> </span></span>Variabel biofisik janin</span></span></b><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#3333FF;"></span></span></span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="color:#3333FF;"><b><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:x-large;">Secara klinis :</span></b></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Kenaikan berat badan ibu</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Pengukuran kenaikan tinggi fundus uteri</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Ukuran lingkar perut ibu.</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Perkiraan berat badan janin</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Palpasi kedudukan & letak janin</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Pemeriksaan denyut jantung janin</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Pemeriksaan keadaaan kesehatan ibu</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;"> </span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:x-large;">Biokimiawi :</span></span></b></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family: Perpetua; font-size: medium; color: rgb(255, 153, 0); font-weight: bold; "><span class="Apple-tab-span" style="white-space:pre"> </span>Kadar alfa fetoprotein :</span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"></span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">NTD (</span><i><span class="Apple-style-span" style="font-size:large;">Neural Tube Defect</span></i><span class="Apple-style-span" style="font-size:large;">)</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Dilakukan saat usia kehamilan 14 – 22 mgg</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-style-span" style="white-space: pre;"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Kadar tergantung pada usia kehamilan, kehamilan ganda, kematian janin</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-family: Georgia, serif; "><span lang="IN" style="font-family:Symbol;"><b><span class="Apple-style-span" style="color:#FF9900;"><span class="Apple-style-span" style="font-size:large;">b</span></span></b></span><span lang="IN" style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#FF9900;"><span class="Apple-style-span" style="font-size:large;">-hCG</span></span></b></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#FF9900;"><span class="Apple-style-span" style="font-size:large;">Pregnancy-associated plasma protein A (PAPP-A)</span></span></b></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Sindroma Down</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Trimester I</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><b><span class="Apple-style-span" style="color:#FF9900;"><span class="Apple-style-span" style="font-size:large;">E</span><span class="Apple-style-span" style="font-size:large;">striol</span></span></b><span class="Apple-style-span" style="font-size:large;"> : menurun drastis tanda gawat janin</span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-family: Georgia, serif; "><span style="font-family:Perpetua;"><span class="Apple-style-span" style="color:#FF9900;"><b><span class="Apple-style-span" style="font-size:large;">Rasio lesitin-sfingomielin</span></b></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"> : menilai kematangan paru</span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-family: Georgia, serif; "><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(255, 153, 0); font-weight: bold; ">Human plasental lactogenic (HPL) : <span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><4><span style="font-family:'Times New Roman';"><span class="Apple-style-span" style="font-size:large;">µ</span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">gr/ml darah tanda fungsi plasenta </span></span></span></span></span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-family: Georgia, serif; "><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(255, 153, 0); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>menurun bermakna hanya pd kehamilan trimester III.</span></span></span></span></span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(255, 153, 0); font-weight: bold; "><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="color:#000000;"><span class="Apple-style-span" style="font-weight: normal;"> </span></span></span>Kadar bilirubin spektrometrik </span><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><span class="Apple-style-span" style="font-size:large;">pada Rh immunisasi.</span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(255, 153, 0); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-family: Georgia, serif; "><span style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#FF9900;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="color:#000000;"><span class="Apple-style-span" style="font-weight: normal;"> </span></span></span>Kadar kreatinin</span></span></b><span class="Apple-style-span" style="font-size:large;"> </span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">pada amnion :<span class="Apple-style-span" style="font-family: Georgia, serif; "><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"> fungsi ginjal</span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"> janin</span></span></span></span></span></span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(255, 153, 0); font-weight: bold; "><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="color:#000000;"><span class="Apple-style-span" style="font-weight: normal;"> </span></span></span>Derajat keasaman (pH )darah janin.</span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Perpetua;color:#3333FF;"><b><br /></b></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family: Perpetua; color: rgb(51, 51, 255); font-weight: bold; ">Genetik</span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family: Perpetua; color: rgb(51, 51, 255); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-family: Georgia, serif; font-weight: normal; "><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>D</span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">ugaan adanya anomali janin</span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family: Perpetua; color: rgb(51, 51, 255); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-family: Georgia, serif; font-weight: normal; "><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Indikasi :</span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family: Perpetua; color: rgb(51, 51, 255); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-family: Georgia, serif; font-weight: normal; "><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Usia ibu > 35 thn</span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family: Perpetua; color: rgb(51, 51, 255); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-family: Georgia, serif; font-weight: normal; "><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Riwayat keluarga terdapat kelainan kongenital atau penyakit bawaan.</span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Perpetua;"><span class="Apple-tab-span" style="white-space:pre"> </span><span class="Apple-style-span" style="font-family: Georgia, serif; "><span lang="IN" style="font-family:'Wingdings 2';"><span style="font: normal normal normal 7pt/normal 'Times New Roman'; "><span class="Apple-tab-span" style="white-space: pre; "><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space: pre; "><span class="Apple-style-span" style="font-size: medium; ">R</span></span></span></span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium; ">iwayat gangguan mental atau gangguan perkembangan pada hamil </span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top: 0in; margin-right: 0in; margin-left: 0.6in; margin-bottom: 0.0001pt; text-align: left; text-indent: -0.25in; "><span class="Apple-style-span" style="font-family: Perpetua; color: rgb(51, 51, 255); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-family: Georgia, serif; font-weight: normal; "><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-family: Georgia, serif; "><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium; "><span class="Apple-tab-span" style="white-space: pre; "> </span>sebelumnya<span class="Apple-style-span" style="font-family: 'Times New Roman'; font-size: 9px; white-space: pre; "><span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family: Perpetua; color: rgb(51, 51, 255); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-family: Georgia, serif; font-weight: normal; "><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-family: Georgia, serif; "><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Adanya riwayat terpapar dengan zat berbahaya atau teratogenik</span></span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family: Perpetua; color: rgb(51, 51, 255); font-weight: bold; "><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-family: Georgia, serif; font-weight: normal; "><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-family: Georgia, serif; "><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Abortus habitualis</span></span></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Perpetua;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo5;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="color: rgb(255, 0, 0); font-weight: bold; "><span class="Apple-style-span" style="font-size: large;">Caranya invasif</span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#FF9900;"><span class="Apple-style-span" style="font-size:large;">Amniosintesis</span></span></b><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Trimester I : 11- 14 minggu</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.2in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Risiko besar :</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.2in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Abortus</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.2in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Kelainan pada janin : fetal clubfoot (talipes)</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.2in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Gagal</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"></span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span></span><span class="Apple-style-span" style="font-size:large;">Trimester II : 15 - 20 minggu</span></span></p><div style="text-align: center;"><br /></div><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEON07oYUzQrLGQu_SI3qfnQDqWmvuAtaWDeA2Z01Krj_dkwXWD9pWrHwREU1GukTxj7EQ1wxRVgqMpDzCEzpUN4jtQtqW6WEIyESMIZAW9fszYDWRtJGtpkhesRloCBka_R0E-L3f5SKj/s200/amniocentesis.gif" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 164px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5412514253315413346" /><div style="text-align: center;"><br /></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj5yGaY7CHBM2r4hJtH3QmVM3Z1UFmXmq9ex3pvOabXsASWDvwQwSszCFqOboxsc8x60epQK8dI9cnxG_LoME8k56cR5stU2kri_KbSKonRVuzmvWMfCGW8FhdGfbIG6pNvkz0gVCAyJBG-/s200/1062.jpg" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 200px; height: 160px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5412513402429072386" /><br /></div><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span><span lang="IN" style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#FF9900;"><span class="Apple-style-span" style="font-size:large;">Chorionic villus sampling (CVS)</span></span></b></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Vili plasenta</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">10 -13 minggu</span></span><span lang="IN" style=" ;font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"></span></span><span lang="IN" style=" ;font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEghOzxg7Z4OuQx-WdPDwzyxI0FGFmEDj2pJ0oNemVNz9Zsgl9tbZ3fOOKJOJxK-Q8w-A-mviWHlh_BJyULOXamJ5ocioTs8ZZH084D9f2ZzMZkrUD6_PC7hpOG-t1Uc-FgpKV4NeU-48D5i/s200/fm-fetascopy.jpg" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 200px; height: 150px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5412514257649985346" /><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span></span><span lang="IN" style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#FF9900;"><span class="Apple-style-span" style="font-size:large;">Percutaneous umbilical cord blood sampling (PUBS)</span></span></b></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="font-size:large;">= cordocentesis = fetal blood sampling</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.9in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Hasil lebih cepat 24 – 48 jam</span></span></p><div style="text-align: center;"><br /></div><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjcWa6FN07CxGUc1iDK1i_kR_zaTsOYu9WbyPVSoMMBiV2u1sJGFZN03tqQIrz14k9QxIRcV33-5WRg1kfyepBZ9Vt4b6SdQI_A9mQgVm2XgoBYHkd73E3DOx2zaHxjwUNbZEVmf0y0F7pq/s200/19177.jpg" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 200px; height: 160px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5412513408416697090" /><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Perpetua;"><o:p><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span><b><span class="Apple-style-span" style="font-size:large;">Keuntungannya:</span></b></span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><o:p><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">L</span><span class="Apple-style-span" style="font-size:large;">ebih dapat meramalkan keadaan janin karena yg diperiksa</span><span class="Apple-style-span"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">adalah</span></span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><o:p><span class="Apple-style-span"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">kadar hasil metabolisme /bahan yg dihasilkan janin </span><span class="Apple-style-span"><span class="Apple-style-span" style="font-size:large;">dan plasenta. </span></span></span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><o:p><span class="Apple-style-span"><span class="Apple-style-span"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">Kadar itu berubah bila terjadi gangguan pada sirkulasi </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;"> fetoplasenter.</span></span></span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span> </span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><b><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="font-size:large;">Kerugiannya:</span></span></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Perpetua;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">Hasil pemeriksaan lama, biayanya mahal dan dapat invasif</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style=" color: rgb(51, 102, 255); font-weight: bold; font-family:Perpetua;"><span class="Apple-tab-span" style="white-space:pre"> </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style=" color: rgb(51, 102, 255); font-weight: bold; font-family:Perpetua;"><span class="Apple-tab-span" style="white-space:pre"></span><span class="Apple-style-span" style="font-size:x-large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Profil biofisik janin</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Didasarkan pada pemeriksaan pola gerak dan gambaran organ janin </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"></span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">Sederhana misalkan pemantauan ibu sendiri</span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"> </span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">: </span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"> </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size:large;"><span lang="IN" style="font-family:Perpetua;"></span></span><span style="font-family:Perpetua;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">merasakan </span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">g</span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">erakan janin,</span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"> </span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">palpasi dan auskultasi.</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.6in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"></span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">Alat elektronik </span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.2in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Fetoskopi</span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.2in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Ultrasonografi</span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:1.2in;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo8;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">K</span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">ardiotokografi</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">Yang diperiksa adalah :</span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">- Gerak nafas janin,gerak janin,tonus janin</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">- Kelainan bentuk tubuh ,letak,biometri janin</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">- Taksiran bb dan umur kehamilan</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">- Jumlah cairan amnion,keadaan dan letak plasenta .</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">- Pola denyut jantung janin & EKG</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"></span></span></span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="color:#FF9900;"><b><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">Gerak janin</span></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="color:#FF9900;"><b><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-size: medium; font-weight: normal; "><span class="Apple-tab-span" style="white-space:pre"> </span>Keadaan & kesehatan janin dpt dinilai dr aktivitas janin dlm rahim.</span></span></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="color:#FF9900;"><b><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-size: medium; font-weight: normal; "><span class="Apple-tab-span" style="white-space:pre"> </span>Pemantauan subjektif (ibu):</span></span></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="color:#FF9900;"><b><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-size: medium; font-weight: normal; "><span class="Apple-style-span" style="font-size: 16px; "><span class="Apple-style-span" style="white-space: pre;"><span class="Apple-style-span" style="font-size: medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>I</span></span><span class="Apple-style-span" style="font-size: medium;">bu diminta memanta</span><span class="Apple-style-span" style="font-family:Georgia, serif;"><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium;">u </span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium;">gerakan janin </span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium;">30-60 menit </span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium;"> </span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium;">3x /hari.</span></span></span></span></span></span></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="color:#FF9900;"><b><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-size: medium; font-weight: normal; "><span class="Apple-style-span" style="font-size: 16px; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium;"><span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Perpetua;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span>Kekurangannya </span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium;">gerak lemah tdk terpantau,</span></span></span></span></span></span></span></span></span></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="color:#FF9900;"><b><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-size: medium; font-weight: normal; "><span class="Apple-style-span" style="font-size: 16px; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium;"><span class="Apple-style-span" style="font-family: Georgia, serif; font-size: 16px; "><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium;"><span class="Apple-style-span" style="font-size: 16px; "><span class="Apple-style-span" style="font-size: medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>Yang bisa dirasakan ibu hanya 40-80%</span><span class="Apple-style-span" style="font-size:large;">.</span></span></span></span></span></span></span></span></span></span></span></b></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"></span></span></span></span><span lang="IN" style="font-family:Perpetua;"><b><span class="Apple-style-span" style="color:#FFCC33;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="color:#FF9900;"><span class="Apple-style-span" style="font-size:large;">Denyut jantung janin</span></span></span></b><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family: Perpetua; "><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="font-size:large;">F</span><span class="Apple-style-span" style="font-size: medium;">rekuensi denyut jantung basal</span></span><br /><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"> </span></span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium;">Normal 120-160 /menit</span></span><br /><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"> </span></span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium;">Takikardia ringan 160 -180/menit.</span></span><br /><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"> </span></span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium;">Takikardia berat </span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium;">> 180/menit.</span></span><br /><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"> </span></span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium;">Bradikardia ringan 100-119/menit</span></span><br /><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size: medium;"> </span></span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size: medium;">Bradikardia berat <></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Perpetua;"><o:p><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Perpetua;"><o:p><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"></span></span><b><span class="Apple-style-span" style="color:#FF9900;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">Ultrasonografi (USG)</span></span></b></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Perpetua;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">Janin sebagai “pasien” :</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Alat diagnostik.</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Memantau perjalanan penyakit & hasil </span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"> </span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">terapi.</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span></span><span style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">Tindakan kuratif.</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0tcR7MM6UReqI7g6xr4xtiBirgTJ7kq0Y6oMPcGZrk8BdrqJWWJvsdkr9V38JC781OFdRe5c09lWnYMqo4uL8-U9DUpqb5XXRnQ5YcvE_6a8EmK8sVNywz6nPhHjtgnItWEVdKcv6PYNf/s200/face.jpg" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 192px; height: 187px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5412514273539703554" /><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span></p><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiDQ14dcgEejP4j0HK_rWEDuDXMwKqpC8Q8m1xtwLuwvQFOmeXlHiBeUZ6HDnv5DvTKCLous9gQuTkiwSYkofE91GfrX2JqZE2PhoomHFkfAAhpxwetP0IgNTKNhzWH47whByCOyL9NUgMC/s200/1.jpg" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 200px; height: 130px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5412514249578106146" /><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:'Times New Roman';"><b><span class="Apple-style-span" style="color:#FF9900;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="color:#000000;"><span class="Apple-style-span" style="font-weight: normal;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span></span></span></b></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:'Times New Roman';"><b><span class="Apple-style-span" style="color:#FF9900;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="color:#000000;"><span class="Apple-style-span" style="font-weight: normal;"><span class="Apple-tab-span" style="white-space:pre"></span></span></span></span><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>K</span></span></b></span></span><b><span class="Apple-style-span" style="color:#FF9900;"><span class="Apple-style-span" style="font-size:large;">ardiotokografi (KTG)</span></span></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" ;font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><b><span class="Apple-style-span" style="color:#FF9900;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><span class="Apple-tab-span" style="white-space:pre"> </span>Kardiotokografi:alat bioelektrik yg berguna dalam menilai</span></span></span></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><o:p><span class="Apple-style-span" style="font-family:Georgia, serif;"><span style="font-family:Perpetua;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">aktivitas </span></span><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;">jantung janin</span></span></span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><o:p><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>Antepartum kardiotokografi: pemantauan pola denyut jantung</span></span></span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><o:p><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>janin (djj) secara eksternal (indirek), sifatnya noninvasif,</span></span></span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><o:p><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>menggunakan 2 transduser : 1 transduser untuk pantau djj</span></span></span></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><o:p><span class="Apple-style-span" style="font-family:Georgia, serif;"><span lang="IN" style="font-family:Perpetua;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>& 1 transduser lainnya untuk pantau kontraksi rahim.</span></span></span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Perpetua;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;"> </span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Perpetua;color:#FF9900;"><b><br /></b></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"></p><div style="text-align: center;"><span class="Apple-style-span" style="font-family:Perpetua;color:#FF9900;"><b><br /></b></span></div><span class="Apple-style-span" style="font-family:Perpetua;color:#FF9900;"><b><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEVxyHd1divs_tZ8yAWS4j-lWDSqGNwUNwOsXGnC6BK2ZWIbwlfYVJwirVE9UCtIVY1a2lo_ZwnAfdvGLY4mdb2jh1DIlKjDud5i2uguTq1W9Lx4M7R-Nc9BsUicQuaSIJW5LMmohlz2cG/s200/300px-Kardiotokograf.jpeg" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 200px; height: 133px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5412513400113112450" /> <br /></b></span><p></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"></p><div style="text-align: center;"><span class="Apple-style-span" style="font-family:Perpetua;color:#FF9900;"><b><br /></b></span></div><span class="Apple-style-span" style="font-family:Perpetua;color:#FF9900;"><b><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEju2poE_KYyHtWvTG_3iQrSm1NLy5XS2R0sejV6Qd7a4F9nrp4AM5N14fehBAv4tCexTDybf0iQIOCub4cZLNEQieMO27iGXbwmB39EEdGsU65CH9xcI-12DgaB1GzEXpm5B5WbvhA90_6-/s200/40.jpg" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 200px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5412513391863585602" /></b></span><br /><p></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"></p><div style="text-align: center;"><br /></div><div style="text-align: left;"><span class="Apple-style-span" style=" color: rgb(255, 153, 0); font-weight: bold; font-family:Perpetua;"><p class="MsoNormal" align="left" style="margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-align: left; text-indent: -0.3in; "><span lang="IN" style=" ;font-family:Perpetua;"><span class="Apple-style-span" style=" ;font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span><span class="Apple-style-span" style="font-size:large;">Fetoskopi</span></span></span></p><p class="MsoNormal" align="left" style="margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-align: left; text-indent: -0.3in; "><span lang="IN" style=" ;font-family:Perpetua;"><span class="Apple-style-span" style=" ;font-size:large;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="color:#FF9900;"><b> </b></span></span>Alat ini dpt melihat langsung janin secara invasif , tapi dengan</span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-align: left; text-indent: -0.3in; "><span lang="IN" style=" ;font-family:Perpetua;"><span class="Apple-style-span" style=" ;font-size:large;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><span class="Apple-tab-span" style="white-space:pre"> </span>kemajuan USG sudah jarang digunakan. Kadang-kadang masih dilakukan </span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-align: left; text-indent: -0.3in; "><span lang="IN" style=" ;font-family:Perpetua;"><span class="Apple-style-span" style=" ;font-size:large;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><span class="Apple-tab-span" style="white-space:pre"> </span>dlm melakukan biopsi janin /mengambil darah langsung dari </span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-align: left; text-indent: -0.3in; "><span lang="IN" style=" ;font-family:Perpetua;"><span class="Apple-style-span" style=" ;font-size:large;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><span class="Apple-tab-span" style="white-space:pre"> </span>vena umbilikalis pada diagnosis kelainan bawaan.</span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-align: left; text-indent: -0.3in; "><span lang="IN" style=" ;font-family:Perpetua;"><o:p><span class="Apple-style-span" style=" ;font-size:large;"><span class="Apple-style-span" style="color:#000000;"> </span></span></o:p></span></p></span></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><br /></div><div style="text-align: center;"><br /></div><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjRVfECyzG3tpCYCFcVTQQhE1GQ4BtnnpSDiNN06ME4BZiBWKPw1K_DUa4898vHVh4z9_-lU04aP7PmznLM3E4IN09VHlhdLEvwfgsvOwcLoV0lPSaU1thrxLrGAT0gin0GV0SJwRKM2LLC/s200/18haftalik.jpg" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 198px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5412513415922668962" /><p></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Perpetua;color:#FF9900;"><b><br /></b></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Perpetua;color:#FF9900;"><b></b></span></p><span class="Apple-style-span" style="font-family:Perpetua;color:#FF9900;"><b><p class="MsoNormal" align="left" style="text-align: right;margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-indent: -0.3in; "><span lang="IN" style="font-size:22.0pt; mso-bidi-font-family:"Wingdings 2";mso-fareast-font-family: "Wingdings 2";mso-bidi-Wingdings 2";mso-font-kerning:12.0ptfont-family:";font-size:26.0pt;"><span style="mso-list:Ignore">—<span style="font:7.0pt "Times New Roman""></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Perpetua;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal"><span lang="IN"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p></b></span><p></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Perpetua;color:#FF9900;"><b><br /></b></span></p><p class="MsoNormal" align="left" style="text-align: justify;margin-top: 0in; margin-right: 0in; margin-left: 0.3in; margin-bottom: 0.0001pt; text-indent: -0.3in; "><span class="Apple-style-span" style="font-family:Perpetua;color:#FF9900;"><b><br /></b></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Perpetua;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.3in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style=" ;font-family:Perpetua;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal"><span lang="IN"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p>DEVIANAhttp://www.blogger.com/profile/01031644635327768252noreply@blogger.com1tag:blogger.com,1999:blog-6730807132725239761.post-27698635397866629422009-12-06T07:08:00.000-08:002009-12-06T07:46:59.627-08:00HIPEREMESIS GRAVIDARUM<i><b><div><br /></div>PENDAHULUAN</b></i><br /><ul><li style="text-align: justify;"><span class="Apple-style-span" style="color:#000066;"><b>Mual & muntah</b> yang dialami oleh ibu hamil pada awal kehamilan</span></li></ul><span class="Apple-style-span" style="color: rgb(0, 0, 102); "><span class="Apple-tab-span" style="white-space:pre"> </span>yang tidak respon terhadap pengaturan diet dan anti emetik</span><br /><ul><li style="text-align: justify;"><span class="Apple-style-span" style="color:#000066;"><b>Sering dialami oleh</b> :</span></li></ul><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="color:#000066;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></span><span class="Apple-style-span" style="color:#000066;"> </span>Kehamilan ganda<br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Molahidatidosa<br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Kondisi yg menyebabkan kadar hormon sangat tinggi<br /><br /><ul><li><span class="Apple-style-span" style="color:#000099;"><b>Dihubungkan dengan :</b></span></li></ul><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Penurunan berat badan<br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Dehidrasi<br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Asidosis<br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Alkalosis<br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Hipokalemia <div><br /><ul><li><span class="Apple-style-span" style="color:#000099;"><b>Laboratorium :</b></span></li></ul><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Hiperbilirubinemia ringan<br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span> Peningkatan fungsi hati<br /><br /><i><b>ETIOLOGI</b></i><br /><ul><li><b><span class="Apple-style-span" style="color:#FF0000;">Hormon hCG</span></b></li></ul><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Paling sering, karena kadar puncak sama dengan onset hiperemesis<br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Terutama dialami oleh ibu dengan kadar hCG tinggi </div><div><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span>(gemelli, molahidatidosa)<br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Mekanisme ?<br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Stimulasi sekresi saluran pencernaan atas<br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Stimulasi fungsi tiroid, karena struktur hCG hampir sama dengan TSH<br /><ul><li><b><span class="Apple-style-span" style="color:#FF0000;">Hormon lain</span></b></li></ul><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> <b>Progesteron ?<br /></b><span class="Apple-tab-span" style="white-space:pre"><b> </b><span class="Apple-tab-span" style="white-space:pre"><b> </b></span></span><b> Estrogen :</b><br /><br /></div><div><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span><i><span class="Apple-style-span" style="color:#000099;">HG terutama ditemukan pada wanita dengan kondisi </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>kadar estrogen tinggi <span class="Apple-style-span" style="color: rgb(0, 0, 0); font-style: normal; "><i><span class="Apple-style-span" style="color:#000099;">seperti : IMT yg </span></i><i><span class="Apple-style-span" style="color:#000099;">tinggi, </span></i></span></span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-style: normal; "><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>pengobatan dengan estrogen, <span class="Apple-style-span" style="color: rgb(0, 0, 0); font-style: normal; "><i><span class="Apple-style-span" style="color:#000099;">karena estrogen dapat </span></i></span></span></i></span></span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-style: normal; "><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-style: normal; "><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>menyebabkan</span></i><i><span class="Apple-style-span" style="color:#000099;"> mual dan muntah</span></i></span></span></i></span></span></i></div><div><span class="Apple-tab-span" style="white-space:pre"><i><span class="Apple-style-span" style="color:#000099;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></i></span><i><span class="Apple-style-span" style="color:#000099;">Estrogen menyebab peristaltik usus dan pengosongan </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>lambung menjadi <span class="Apple-style-span" style="color: rgb(0, 0, 0); font-style: normal; "><i><span class="Apple-style-span" style="color:#000099;">lambat sehingga </span></i><span class="Apple-tab-span" style="white-space:pre"><i><span class="Apple-style-span" style="color:#000099;"> </span></i></span><i><span class="Apple-style-span" style="color:#000099;">terjadi akumulasi cairan </span></i></span></span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-style: normal; "><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>akibat peningkatan hormon steroid.</span></i></span></span></i></div><div><span class="Apple-tab-span" style="white-space:pre"><i><span class="Apple-style-span" style="color:#000099;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></i></span><i><span class="Apple-style-span" style="color:#000099;">Perubahan pH saluran cerna menyebankan infeksi </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>helycobacter pylori, <span class="Apple-style-span" style="color: rgb(0, 0, 0); font-style: normal; "><i><span class="Apple-style-span" style="color:#000099;">yang juga </span></i><i><span class="Apple-style-span" style="color:#000099;">dihubungkan dengan</span></i></span></span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-style: normal; "><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span> gejala gangguan pencernaan</span></i></span></span></i></div><div><br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> <b>Hormon tiroid</b></div><div><br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span><i><span class="Apple-style-span" style="color:#000099;">Reseptor hormon tiroid sensitif terhadap hCG, sehingga terjadi </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>TSH <span class="Apple-style-span" style="color: rgb(0, 0, 0); font-style: normal; "><i><span class="Apple-style-span" style="color:#000099;">menurun dan T3 dan </span></i><span class="Apple-tab-span" style="white-space:pre"><i><span class="Apple-style-span" style="color:#000099;"> </span></i></span><i><span class="Apple-style-span" style="color:#000099;">T4 bebas meningkat</span></i></span></span></i></div><div><span class="Apple-style-span" style="color:#000099;"><i><br /></i></span><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> <b>Korteks adrenal</b></div><div><br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span><i><span class="Apple-style-span" style="color:#000099;">Kortisol rendah dihubungkan dengan HG<br /></span></i><span class="Apple-tab-span" style="white-space:pre"><i><span class="Apple-style-span" style="color:#000099;"> <span class="Apple-tab-span" style="white-space:pre"> </span></span></i></span><i><span class="Apple-style-span" style="color:#000099;">Respon terhadap pengobatan dengan terapi kortikosteroid</span></i></div><div><span class="Apple-style-span" style="color:#000099;"><i><br /></i></span><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> <b>Leptin</b></div><div><br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span><i><span class="Apple-style-span" style="color:#000099;">Mengurangi nafsu makan dan bekerja sama dengan cortisol, </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>hormon tiroid</span></i></div><div><span class="Apple-style-span" style="color:#000099;"><i><br /></i></span><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> <i><b>Growth hormone</b></i><b> dan prolaktin ?</b><br /><br /><ul><li><b><span class="Apple-style-span" style="color:#FF0000;">Imunologi</span></b></li></ul><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> IL-6, TNF alfa. T-helper2, imunoglobulin, C3, C4<br /><ul><li><b><span class="Apple-style-span" style="color:#FF0000;">Saluran Pencernaan</span></b></li></ul><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Helycobacter pylori<br /><ul><li><b><span class="Apple-style-span" style="color:#FF0000;">Defisiensi vitamin : thiamin dan vit.K</span></b></li><li><b><span class="Apple-style-span" style="color:#FF0000;">Faktor psikologi</span></b></li></ul><br /><b><i>TERBAGI ATAS 3 DERAJAT :</i></b><br /><br /><ul><li><b><span class="Apple-style-span" style="color:#FF0000;">Derajat 1 </span></b></li></ul><i><div style="text-align: justify;"><span class="Apple-style-span" style="color: rgb(0, 0, 153); "><span class="Apple-tab-span" style="white-space:pre"> </span>Muntah terus menerus (muntah > 3-4 kali/hari, dan tidak dapat <span class="Apple-tab-span" style="white-space:pre"> </span></span></div></i></div><div style="text-align: justify;"><span class="Apple-style-span" style="color:#000099;"><i><span class="Apple-tab-span" style="white-space:pre"></span></i><span class="Apple-tab-span" style="white-space:pre"><i> </i></span><i>makan atau minum selama 24 jam) yang menyebabkan ibu </i></span></div><div style="text-align: justify;"><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"><i> </i></span><i>menjadi lemah, tidak ada nafsu makan, </i></span></div><div style="text-align: justify;"><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"><i> </i></span><i>berat badan turun (2-3 kg dalam 1-2 minggu), nyeri ulu hati, </i></span></div><div style="text-align: justify;"><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"><i> </i></span><i>nadi meningkat sampai 100x permenit, </i></span></div><div style="text-align: justify;"><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"><i> </i></span><i>tekanan darah sistolik menurun, </i></span></div><div><div style="text-align: justify;"><span class="Apple-style-span" style="color: rgb(0, 0, 153); "><span class="Apple-tab-span" style="white-space:pre"><i> </i></span><i>tekanan </i><span class="Apple-tab-span" style="white-space:pre"><i> </i></span><i>kulit menurun dan mata cekung</i></span></div><div style="text-align: justify;"><br /></div><br /><ul><li><b><span class="Apple-style-span" style="color:#FF0000;">Derajat 2 </span></b></li></ul><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>Penderita tampak lebih lemah dan tidak peduli pada sekitarnya, </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>nadi kecil dan cepat, suhu kadang-kadang naik </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>dan mata sedikit kuning. </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>Berat badan turun dan mata menjadi cekung, tekanan darah turun, </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>pengentalan darah, urin berkurang, dan sulit BAB. </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>Dari napas dapat tercium bau aseton<br /></span></i><br /><ul><li><b><span class="Apple-style-span" style="color:#FF0000;">Derajat 3 </span></b></li></ul><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>Keadan umum lebih parah, muntah berhenti, kesadaran menurun </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>sampai koma, nadi kecil dan cepat, suhu meningkat, dan </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>tekanan darah turun. </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>Pada janin dapat<span class="Apple-tab-span" style="white-space:pre"> </span>terjadi </span><span class="Apple-style-span" style="color:#CC0000;">ensefalopati Wernicke</span><span class="Apple-style-span" style="color:#000099;"> </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>dengan gejala: nistagmus, penglihatan ganda, dan perubahan mental. </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>Keadaan ini akibat kekurangan zat makanan termasuk </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>vitamin B kompleks. </span></i></div><div><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span>Jika sampai ditemukan kuning berarti sudah ada gangguan hati</span></i></div><div><span class="Apple-style-span" style="color:#000099;"><i><br /></i></span><b><i>PEMERIKSAAN PENUNJANG</i></b><br /><ul><li><b><span class="Apple-style-span" style="color:#FF0000;">Urin </span></b></li></ul><span class="Apple-tab-span" style="white-space:pre"> </span> keton, bilirubinuria<br /><ul><li><b><span class="Apple-style-span" style="color:#FF0000;">Darah </span></b></li></ul><span class="Apple-tab-span" style="white-space:pre"> </span> elektrolit darah, ureum, kreatinin, glukosa, fungsi hati, fungsi tiroid<br /><ul><li><b><span class="Apple-style-span" style="color:#FF0000;">USG</span></b> </li></ul><span class="Apple-tab-span" style="white-space:pre"> </span> usia gestasi janin, adanya gestasi multipel, </div><div><span class="Apple-tab-span" style="white-space:pre"> </span>mendeteksi abnormalitas janin, kehamilan mola.<br /><br /><b><i>PENANGANAN</i></b><br /><ul><li><span class="Apple-style-span" style="color:#FF0000;"><b>Atur pola makan</b></span> : porsi kecil tapi sering dan </li></ul><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span>hindari makanan yang mimicu muntah<br /><ul><li><span class="Apple-style-span" style="color:#FF0000;"><b>Pengobatan</b></span> :</li></ul><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Vitamin B6<br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Antiemetik : </div><div><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span>promethazine ( 25 mg/6jam), prochlorperazine, chlorpromazine<br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Untuk kasus yang berat : </div><div><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span>metoclopramide (10 mg/6 jam), ondansetron<br /><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span> Atasi dehidrasi, defisit elektrolit dan keseimbangan asam basa : </div><div><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span>cairan kristaloid IV<br /><br /><b><i>KOMPLIKASI</i></b><br /><ul><li>Syndrom Mallory –Weiss</li><li>Robekan pada esofagus</li><li>Pneumotoraks</li><li>Pneumomediastinum</li><li>Epistaksis </li><li>Ensefalopati Wernicke (buta, kejang dan koma)</li></ul><b><i>DIAGNOSIS BANDING</i></b><br /><ul><li>Gastroenteritis</li><li>Kolesistitis</li><li>Pankreatitis</li><li>Hepatitis</li><li>Ulkus peptik</li><li>Fatty liver akut</li></ul><br /></div>DEVIANAhttp://www.blogger.com/profile/01031644635327768252noreply@blogger.com0tag:blogger.com,1999:blog-6730807132725239761.post-6777768183558269162009-12-05T20:49:00.004-08:002009-12-06T05:40:20.055-08:00ASUHAN ANTE NATAL<span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; font-family:Corbel;"><span class="Apple-style-span" style="font-size:x-large;">Tujuan Asuhan Antenatal :</span></span><br /><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"></p><ul><li><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">Kesehatan fisik, mental dan sosial ibu dan bayi, melalui edukasi : nutrisi, personal hygiene <span class="Apple-tab-span" style="white-space:pre"> </span>dan <span class="Apple-tab-span" style="white-space:pre"> </span>proses persalinan</span></span></li><li><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:medium;">Deteksi & penanganan komplikasi kehamilin</span></li><li><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:medium;">Mempersiapkan dan merencanakan persalinan dan terutama bila terjadi komplikasi</span></li><li><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:medium;">Membantu ibu untuk dapat menyusui secara ekslusif, melalui masa nifas secara normal dan <span class="Apple-tab-span" style="white-space:pre"> </span>perawatan yang baik terhadap bayi baik secara fisik, psikologi dan sosial.</span></li></ul><span class="Apple-style-span" style="font-family:Corbel;"><br /></span><span class="Apple-style-span" style=" color: rgb(0, 0, 153); font-weight: bold; font-family:Corbel;font-size:x-large;">Kunjungan pertama :</span><br /><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><b><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:x-large;"><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); "><span class="Apple-style-span" style="font-size:7;"><span class="Apple-style-span" style=" white-space: pre;font-size:43px;"> </span></span></span><span class="Apple-style-span" style="color:#FF0000;"><span class="Apple-style-span" style="font-size:large;">Harus seawal mungkin.</span></span></span></span></span></b></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"></p><ul><li><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:large;">Anamnesis : umur, paritas, HPM, riwayat haid</span></li><li><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> Pemeriksaan fisik </span></span><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">à</span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> TB, BB, T, dan pemeriksaan kehamilan.</span></span></li><li><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> Pemeriksaan laboratorium </span></span><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">à</span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> Hb, Hmt, gol darah, rhesus</span></span></li><li><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:large;"> Pemeriksaan tambahan lain untuk memperoleh data (parameter) dasar</span></li><li><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> Support psikis </span></span><span lang="IN" style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">à</span></span><span lang="IN" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> agar ibu hamil memiliki emosi stabil.</span></span></li></ul><span class="Apple-style-span" style=" font-weight: bold; font-family:Corbel;"> <span class="Apple-style-span" style="color:#000099;"> </span></span><span class="Apple-style-span" style=" font-weight: bold; font-family:Corbel;"><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="font-size:x-large;">Tanda Kehamilan</span></span></span><p></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:large;"></span></p><blockquote></blockquote><span class="Apple-tab-span" style="white-space:pre"> </span> <span class="Apple-style-span" style="color:#000099;"><b><i>Tanda pasti kehamilan :</i></b></span><br /><ul><li><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:large;">Palpasi</span></li><li><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:large;">Denyut jantung janin</span></li><li><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Stetoskop Laennec /fetoscop </span></span><span style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">à</span></span><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> 18 minggu</span></span></li><li><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:large;">Doppler : 12 minggu</span></li><li><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:large;">Ultrasound :</span></li></ul><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span> <span class="Apple-tab-span" style="white-space:pre"> </span>6-7 minggu : <i>fetal pool</i></span><br /><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span>7-8 minggu : denyut jantung janin</span><br /><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span>8-9 minggu : gerakan anak</span><br /><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span>9-10 minggu : plasenta</span><br /><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:large;"> <span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span></span>12 minggu : Diameter biparietal (<i>BPD : biparietal diameter</i>).</span><br /><ul><li><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:large;">Tes hCG</span></li></ul><p></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b><i><span class="Apple-style-span" style="color:#000099;"><span class="Apple-tab-span" style="white-space:pre"> </span><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-style-span" style="font-size:large;">T</span><span class="Apple-style-span" style="font-size:large;">anda Kemungkinan hamil :</span></span></i></b></span><o:p></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:medium;"> à</span></span><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;"> Amenorea , mual dan muntah, mastodinia, gerak<span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;">an anak, frekuensi berkemih meningkat, konstipasi, penambahan berat badan, peningkatan suhu badan basal, kloasma</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:x-large;"><b><br /></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><b><span style="font-family:Corbel;"><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="font-size:x-large;">Menentukan usia kehamilan</span></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><b><span class="Apple-style-span" style="font-size:large;">¡</span></b><span style="font:7.0pt "Times New Roman""><b><span class="Apple-style-span" style="font-size:large;"> </span></b></span></span><span style="font-family:Corbel;"><b><i><span class="Apple-style-span" style="font-size:large;">Naegele’s rule</span></i></b></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:medium;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> Taksiran partus (TP : </span></span></span><span style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">EDC : estimated day of confinement) </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">=(HPHT +7) (bulan-3) (tahunr +1)</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;"> </span></span><span style="font-family:Wingdings;"><span class="Apple-style-span" style="font-size:medium;">è</span></span><span style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;"> contoh : HPH</span><span class="Apple-style-span" style="font-size:medium;">T </span></span><st1:date year="2004" day="26" month="4"><span style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">26/4/2004</span></span></st1:date><span style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;"> </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;"> TP </span></span><st1:date year="2005" day="2" month="3"><span style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">3/2/2005</span></span></st1:date><span style="font-family:Corbel;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;font-size:28.0pt;"><o:p></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><br /></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><b>¡</b></span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"><b> <span class="Apple-style-span" style="font-family:'lucida grande';"><span class="Apple-style-span" style="font-size: medium;">Tinggi fundus uteri</span></span></b></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:'lucida grande';"><span class="Apple-style-span" style="font-size:medium;"><b><br /></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhm2dOPuSqNLHW1Zv_esY1O74tw32Rke7c_ejLq-DuXO4cFTanAVhtcoGRZ5LNiM77cKadlJlq7jTDgBpeMbccNdbhxd2mRRiqTgSu9f5pAoTjA0WWrfczuNNcD3OVo_rODrK5xYOXqpQpk/s200/uterus.jpg" style="cursor:pointer; cursor:hand;width: 165px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5411995079099010706" /></b></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Corbel;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;font-size:32.0pt;"><o:p> </o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"><b>¡</b></span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"><b> </b></span></span></span><span style="font-family:Corbel;"><b><i><span class="Apple-style-span" style="font-size:large;">Quickening</span></i><span class="Apple-style-span" style="font-size:large;">: </span></b><o:p></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span style="font-family:Corbel;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span></span><span class="Apple-style-span" style=" ;font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>16 minggu pada multigravida</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>18 minggu pada primigravida</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><br /></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span style=" ;font-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;">¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span><span class="Apple-style-span" style="font-size:large;">Taksiran berat janin</span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style=" font-weight: bold; font-family:Corbel;font-size:large;"><span class="Apple-style-span" style="font-family:'Times New Roman';"><span class="Apple-style-span" style="font-weight: normal;"> - </span></span><i><span class="Apple-style-span" style="color:#990000;">Johnson’s estimate of fetal w</span><span class="Apple-style-span" style=" font-style: normal; font-weight: normal; font-family:Georgia, serif;"><span class="Apple-style-span" style=" font-style: italic; font-weight: bold; font-family:Corbel;"><span class="Apple-style-span" style="color:#990000;">eight (EFW) </span></span></span></i></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>EFW = (fundal height – N) x155</span><br /><span style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:medium;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">N = 12, if the vertex is at or above the ischial spine.</span></span><br /><span style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:medium;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">N = 11, if the vertex is below the spines.</span></span><br /><span style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>à </span></span><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">Contoh : </span></span><br /><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span><span class="Apple-tab-span" style="white-space:pre"> </span>G3P1A1, examination fundal heigh was 34 cm, the head is floating.</span><br /><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span><span class="Apple-tab-span" style="white-space:pre"> </span>EFW = (34-12)x155 = 3410 g.</span><br /><span class="Apple-style-span" style=" font-weight: bold; font-family:Corbel;font-size:medium;">- Tinggi fundus uteri X lingkar perut setinggi pusat</span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><b><br /></b></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:x-large;"><b><br /></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><b><span class="Apple-style-span" style="font-size:x-large;">Apa Yang Dilakukan Saat Pemeriksaan ANC</span></b></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo7;mso-layout-grid-align:none; text-autospace:none"><b><span style="font-family:Corbel;"><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span"><span class="Apple-style-span" style="font-size:large;">- </span></span><span class="Apple-style-span" style="font-size:large;">Nilai Kesehatan ibu hamil</span></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"> ¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Tentukan status kesehatan ibu</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> Identifikasi faktor risiko yang dapat mempengaruhi hasil luaran kehamilan </span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style=""> </span></span></span><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Usia </span></span><span style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">à</span></span><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> <> 40 tahun</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Grande multipara</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Tinggi badan : terlalu pendek ?</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Riwayat obstetri yang lalu : ada komplikasi ? pembedahan ?</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#FF0000;"> Y</span></span></span></span><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#FF0000;">ang paling penting adalah mengidentifikasi dan menangani faktor risiko dan komplikasi yang dialami oleh ibu hamil.</span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;color:#FF0000;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#FF0000;"> </span></span><o:p></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><b><span style="font-family:Corbel;"><span class="Apple-style-span" style="color:#000099;"><span class="Apple-style-span" style="font-size:large;">- Deteksi dan penanganan komplikasi </span></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"> ¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Identifikasi adanya risiko perdarahan hamil muda, khususnya <i>unsafe abortion</i> perdarahan <span class="Apple-tab-span" style="white-space:pre"> </span>antepartum.</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style=" ;font-family:'Wingdings 2';"><span class="Apple-style-span" style="font-size:large;"> ¡</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Komplikasi lain : hypertensive disease, anemia, diabetes, malaria, </span></span><st1:stockticker><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">STD</span></span></st1:stockticker><span style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">, membutuhkan <span class="Apple-tab-span" style="white-space:pre"> </span>pemeriksaan yang lebih teliti </span><o:p></o:p></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;color:#000099;"><span class="Apple-style-span" style="font-size:x-large;"><b>- <span class="Apple-style-span" style="font-size:x-large;">P</span><span class="Apple-style-span" style="font-size:large;">antau dan catat dalam rekam medis</span></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;color:#000099;"><span class="Apple-style-span" style="font-size:x-large;"><b><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; white-space: pre; font-family:Georgia, serif;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Corbel;color:#000099;"><b> <span class="Apple-tab-span" style="white-space:pre"> </span></b></span> </span> Tekanan darah</span></b></span></span></p><span class="Apple-style-span" style="white-space: pre; "><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span>Nilai apakah terdapat edema</span><br /><span class="Apple-style-span" style="white-space: pre; "><span class="Apple-tab-span" style="white-space:pre"> </span> <span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span>Tinggi fundus uteri</span><br /><span class="Apple-style-span" style="white-space: pre; "> <span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span>Denyut jantung janin</span><br /><span class="Apple-style-span" style="white-space: pre; "><span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span>Presentasi janin</span><div><span class="Apple-style-span" style="white-space: pre; "><span class="Apple-style-span" style=" ;font-family:Corbel;"> </span></span> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><b><span style="mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:x-large;"><span class="Apple-style-span" style="color:#000099;">- <span class="Apple-style-span"><span class="Apple-style-span" style="font-size:large;">Nutrisi ibu hamil</span></span></span></span><o:p></o:p></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo2;mso-layout-grid-align:none; text-autospace:none"></p><ul><li><span class="Apple-style-span" style=" ;font-family:Corbel;"> Gizi ibu berperan penting dalam pertumbuhan dan perkembangan janin </span></li><li><span class="Apple-style-span" style=" ;font-family:Corbel;"> Kebutuhan ibu hamil : 2300 kcal/ hari </span></li><li><span class="Apple-style-span" style=" ;font-family:Corbel;">Supplementary Suplemen lain perlu ditambahkan bila diyakini asupan zat penting dan mineral tidak adekuat f</span></li><li>Pemberian vitamin/suplemen oleh petugas kesehatan dapat membantu dalam meningkatkan kunjungan ibu hamil untuk memeriksakan kehamilan</li><li><span class="Apple-style-span" style=" ;font-family:Corbel;">Amati adanya tanda-tanda anemia zat besi dan defisiensi iodine</span></li><li><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-family:Georgia, serif;">Suplemen </span>kalsium diberikan kepada ibu hamil untuk memenuhi kebutuhan janin dan cadangan kalsium ibu </span></li><li>Zat besi dibutuhkan oleh ibu hamil selain untuk janin, juga untuk mencegah pengurangan cadangan besi ibu, khususnya pada trimestert terakhir kehamilan Merupakan suplemen yang dianjurkan diberikan secara rutin kepada ibu hamil.</li></ul><p></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo9;mso-layout-grid-align:none; text-autospace:none"><b><span style="font-family:Corbel;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style=" ;font-size:x-large;"><span class="Apple-style-span" style="color:#000099;">- <span class="Apple-style-span" style="font-size:large;">Edukasi</span></span></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Wingdings;"><span><span class="Apple-style-span" style=" ;font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">Menentukan tempat untuk b</span><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">ersalin </span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><i>Clean delivery</i></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Perhatikan tanda bahaya kehamilan (perdarahan, nyeri perut, sakit kepala, pecah ketuban, anak tidak bergerak) </span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">Kapan dan di mana temp</span><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">at untuk mencari pertolongan bila terjadi komplikasi </span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> N</span></span></span></span><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">utrisi ibu</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><st1:stockticker><span style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0pt; mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">STD</span></span></st1:stockticker><span style="font-family:Corbel;mso-bidi-mso-font-kerning:12.0pt; mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">/HIV/AIDS </span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><i>F</i><i>amily planning</i></span></span></p><p class="MsoNormal" align="left" style="text-align: left;margin-top: 0in; margin-right: 0in; margin-left: 0.8in; margin-bottom: 0.0001pt; text-indent: -0.3in; "><span class="Apple-style-span" style="font-family:Corbel;color:#3333FF;"><span class="Apple-style-span" style="font-size:x-large;"><b><br /></b></span></span></p><p class="MsoNormal" align="left" style="text-align: left;margin-top: 0in; margin-right: 0in; margin-left: 0.8in; margin-bottom: 0.0001pt; text-indent: -0.3in; "><span class="Apple-style-span" style=" color: rgb(51, 51, 255); font-weight: bold; font-family:Corbel;font-size:x-large;">Pencegahan </span></p><p class="MsoNormal" align="left" style="text-align: left;margin-top: 0in; margin-right: 0in; margin-left: 0.8in; margin-bottom: 0.0001pt; text-indent: -0.3in; "><span class="Apple-style-span" style=" color: rgb(51, 51, 255); font-weight: bold; font-family:Corbel;"><span class="Apple-style-span" style="color: rgb(0, 0, 0); font-weight: normal; "><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="white-space: pre; "><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>- </span></span></span><span class="Apple-style-span" style="font-size:medium;">Pemberian zat besi dan asam fola</span><span class="Apple-style-span" style="font-family:Georgia, serif;"><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">t </span></span><span style="font-family:Wingdings; mso-ascii-font-family:Corbel;mso-hansi-font-family:Corbel;mso-bidi-font-family: Corbel;mso-font-kerning:12.0pt;mso-ansi-language:EN-US;mso-char-type:symbol; mso-symbol-font-family:Wingdings;"><span style="font-family:Wingdings;"><span class="Apple-style-span" style="font-size:medium;">à</span></span></span><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;"> di negara berkembang anemia ibu </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">hamil sekitar </span><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">60% </span></span></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-size:medium;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;"> - I</span></span></span><span class="Apple-style-span" style="font-size:medium;">mm</span><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">un</span><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">isasi toksoid tetanus</span></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-size:medium;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;"> - </span></span></span><span class="Apple-style-span" style="font-size:medium;">supplemen vit A bagi yang membutuhkan (hati-hati, vit. A bersifat </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">terato</span><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">genik)</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-size:medium;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;"> - </span></span></span><span class="Apple-style-span" style="font-size:medium;">Pemberian antimalarials pada daerah endemik</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:";"><span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span> - </span></span></span><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">Antihelminthic</span><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span"><span class="Apple-style-span" style="font-size:medium;">s (hookworm) di daerah endemik</span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-size:medium;"> </span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;"> - </span></span></span><span class="Apple-style-span" style="font-size:medium;">Garam beryodium [ada daerah endemik </span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo9;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size:7;"><span class="Apple-style-span" style="font-size:43px;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo9;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style=" ;font-size:large;"><b>TAHAP PEMERIKSAAN</b></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style=" ;font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span>Catat nama, alamat, tanggal lahir, dan informasi sosial lain pasien </span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo9;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size:large;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo9;mso-layout-grid-align:none; text-autospace:none"><b><span style="font-family:Corbel;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#990000;">PEMERIKSAAN UMUM</span></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span></span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Tanda vital : tekanan darah, nadi , suhu, respirasi </span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span>Catat berat badan, tinggi badan, status gizi </span></span></p><span class="Apple-style-span" style="font-size:large;"> </span><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span>Nilai kondisi umum (kulit, rambut, leher, payudara, abdomen, extremitas)</span></span></p><span class="Apple-style-span" style="font-size:large;"> </span><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span><span class="Apple-style-span" style="font-size:medium;">Pemeriksaan panggul : vulvar , vagina, varisess, konsistensi serviks, posisi, </span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;"><span class="Apple-tab-span" style="white-space:pre"> </span>penipisan, dilata</span><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">si, massa, u</span><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">kuran panggul. </span></span></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style=" ;font-size:large;"><span class="Apple-style-span" style="color:#990000;">ANAMNESIS</span></span></p><span class="Apple-style-span" style="font-size:large;"> </span><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-family:Georgia, serif;"> <span class="Apple-tab-span" style="white-space:pre"> </span>- </span><b><span class="Apple-style-span" style="font-size:medium;">Riwayat obstetri </span></b></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">Hari pertama haid terakhir (HPHT)</span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Arial;mso-fareast-mso-font-kerning:12.0ptfont-family:Arial;"><span><span class="Apple-style-span" style="font-size: medium;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: medium;"> </span><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">lama haid, reguler/ireguler</span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Arial;mso-fareast-mso-font-kerning:12.0ptfont-family:Arial;"><span><span class="Apple-style-span" style="font-size: medium;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: medium;"> </span><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">Meto</span><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">de KB sebelum hamil</span></span></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size: medium;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: medium;"> </span><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">Gejala hamil :</span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Arial;mso-fareast-mso-font-kerning:12.0ptfont-family:Arial;"><span><span class="Apple-style-span" style="font-size: medium;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: medium;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">Mual & muntah</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Arial;mso-fareast-mso-font-kerning:12.0ptfont-family:Arial;"><span><span class="Apple-style-span" style="font-size: medium;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: medium;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">Frekuensi berkemih meningkat</span><span class="Apple-style-span" style="font-size: medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Arial;mso-fareast-mso-font-kerning:12.0ptfont-family:Arial;"><span><span class="Apple-style-span" style="font-size: medium;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: medium;"> </span><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">Lelah yang berlebihan</span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Arial;mso-fareast-mso-font-kerning:12.0ptfont-family:Arial;"><span><span class="Apple-style-span" style="font-size: medium;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: medium;"> </span><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">Nyeri payudara</span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Arial;mso-fareast-mso-font-kerning:12.0ptfont-family:Arial;"><span><span class="Apple-style-span" style="font-size:medium;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> G</span><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">erakan anak sudah diras</span><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">akan atau belum</span></span></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Corbel;mso-bidi- mso-font-kerning:12.0ptfont-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:medium;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:";"><span><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">- </span><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">Riwayat obstetri yang lalu</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">Gravid & paritas, jumlah anak hidup</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">Riwayat kehamilan sebelumnya </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: medium;"> </span><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">Riwayat ginekologi</span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size: medium;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: medium;"> </span><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">Riwayat masalah medis</span><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;"> </span></span></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Arial;mso-fareast-mso-font-kerning:12.0ptfont-family:Arial;"><span><span class="Apple-style-span" style="font-size: medium;"> ▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: medium;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">DM, penyakit ginjal</span><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">, hypertensi, penyakit jantung, thyrotoxicosis, TBC, </span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;"> hepatitis, HIV</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size: medium;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: medium;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">Riwayat keluarga</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size: medium;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: medium;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">Medikasi, alergi obat , riwayat alergi lainnya</span><span class="Apple-style-span" style="font-size: medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size: medium;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size: medium;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size: medium;">Faktor sosial</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style=" ;font-size:large;"><br /></span></span></p><span class="Apple-style-span" style="font-size:large;"> </span><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Corbel;mso-bidi- mso-font-kerning:12.0ptfont-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="color:#990000;">PEMERIKSAAN OBSTETRI</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style=" ;font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span></span><span><span class="Apple-style-span" style="font-size:large;">Tinggi badan</span></span><span class="Apple-style-span" style="font-size:large;">: panggul kecil ?</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span>Berat badan</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style=" ;font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span>Tekanan darah : posisi baring miring kiri untuk menghindari takenan pada vena <span class="Apple-tab-span" style="white-space:pre"> </span>kava oleh <span class="Apple-tab-span" style="white-space:pre"> </span>rahim yang membesar </span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span>Kepala & leher</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style=" ;font-size:large;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Chloasma</span></span></p><span class="Apple-style-span" style=" ;font-size:large;"> </span><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Anemia</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style=" ;font-size:large;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Ikterus</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Dental hygiene</span></span></p><span class="Apple-style-span" style="font-size:large;"> </span><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Thyroid </span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span>Payudara</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style=" ;font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span></span><span><span class="Apple-style-span" style="font-size:large;">jantung </span></span><span class="Apple-style-span" style="font-size:large;">& paru-paru</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Corbel;mso-bidi- mso-font-kerning:12.0ptfont-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Corbel;mso-bidi- mso-font-kerning:12.0ptfont-family:Corbel;"><o:p><span class="Apple-style-span" style="font-size:large;"> </span></o:p></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span>Abdomen</span></span></p><span class="Apple-style-span" style="font-size:large;"> </span><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Striae gravidarum</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style=" ;font-size:large;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Linea nigra</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Hepatosplenom</span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">egaly ?</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style=" ;font-size:large;"> §</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Fundal height </span><span><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Arial;mso-fareast-mso-font-kerning:12.0ptfont-family:Arial;"><span><span class="Apple-style-span" style="font-size:large;"> ▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Measurement of </span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">symphysial – fundal height</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Arial;mso-fareast-mso-font-kerning:12.0ptfont-family:Arial;"><span><span class="Apple-style-span" style="font-size:large;"> ▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Measurment of abdominal girth</span></span></p><span class="Apple-style-span" style="font-size:large;"> </span><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Arial;mso-fareast-mso-font-kerning:12.0ptfont-family:Arial;"><span><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span><span class="Apple-style-span" style="font-size:large;"> </span></span><span class="Apple-style-span" style="font-size:large;">Leopold</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Arial;mso-fareast-mso-font-kerning:12.0ptfont-family:Arial;"><span><span class="Apple-style-span" style=" ;font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Denyut jantung janin</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span"><i><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;">Leopold e</span></span></i><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-family:Corbel;"><i><span class="Apple-style-span" style="color:#3333FF;"><span class="Apple-style-span" style="font-size:large;">xamination</span></span></i></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style=" ;font-size:large;"><span class="Apple-style-span" style=" ;font-size:16px;"><span class="Apple-style-span" style=" ;font-size:large;"> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhRBPReNBBADavUkTjjL8YlTVrVz52cE4XQc0JtoLr-njyy6tDjqORJfgGL-BeLz12jqdk15I1tde-oyXN3JEoipd-TGVJqN6CxZglysRmcVMAOykuO7KmDsSFrWWZhPzsZlT7vFuK_DbNd/s200/Picture1.gif" style="cursor:pointer; cursor:hand;width: 191px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5411999711714539634" /></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="color:#990000;"><span class="Apple-style-span" style=" ;font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="color:#990000;"><b>PEMERIKSAAN PANGGUL </b></span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-size:16px;"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> </span></span><span class="Apple-style-span" style="color:#FF0000;"><b><span class="Apple-style-span" style="font-size: large;">Tidak rutin dilakukan</span></b></span></span></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">External genitalia</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Vagina</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Arial;mso-fareast-mso-font-kerning:12.0ptfont-family:Arial;"><span><span class="Apple-style-span" style=" ;font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">sekresi serviks meningkat</span></span></p><span class="Apple-style-span" style="font-size:large;"> </span><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Cervix</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:78.5pt;margin-bottom:.0001pt;text-align:left; text-indent:-.25in;mso-list:l0 level1 lfo10;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Arial;mso-fareast-mso-font-kerning:12.0ptfont-family:Arial;"><span><span class="Apple-style-span" style="font-size:large;">▪</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">lunak (tanda hegar)</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style=" ;font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Uterus</span></span></p><span class="Apple-style-span" style="font-size:large;"> </span><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Adnexa</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Clinical pelvimetri</span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;color:#000099;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style=" ;font-size:large;"><span class="Apple-style-span" style="color:#000099;">Pemeriksaan bimanual</span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiMfDqatgOFJOvzytb3f-RjipOcVeztKbhT7i3tri6nrJAu-nThJeuq-a_mFWnqsncfB_8r9fYbEsf_Um9T4ikOribooRyhCsBEc8zll8hMP-QOnfEif9nsDuG03c9IFKy6nktWuvnojjgS/s200/pdv.jpg" style="cursor:pointer; cursor:hand;width: 200px; height: 162px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5411999715516017858" /><span class="Apple-style-span" style=" ;font-family:Georgia, serif;font-size:16px;"><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdtXL-Yg1e32aAy2EJbx3a-LF0Yxae6uzDZD-yiumbURdidveQHgK7rN3YQ4T7poqSuBIyx2GAqHWGD5GqwK6fmGY3pKmQSZI7EE1bt1AK7JjTER6JA5PemfMx0fl7-BAG-1dr1DobBc6h/s200/Picture2.jpg" style="cursor:pointer; cursor:hand;width: 200px; height: 150px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5411999722210225330" /></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo9;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b><br /></b></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo9;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b><span class="Apple-style-span" style="color:#990000;">PEMERIKSAAN LABORATORIUM</span></b></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> <span class="Apple-style-span" style="font-size:medium;"> <span class="Apple-tab-span" style="white-space:pre"> </span> </span><span class="Apple-style-span" style=" white-space: normal; "><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">Full blood count</span></span></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">Urinalysis</span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">HBs Ag</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:medium;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;">VDRL</span></span><span style="font-family:Corbel;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><b><span style="font-family: Corbel;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-style-span" style="font-family:Georgia, serif;"><span class="Apple-style-span" style="font-weight: normal;"><span class="Apple-style-span" style="color:#990000;">DIAGNOSIS, PROGNOSIS, PERENCANAAN & PENANGANAN </span></span></span></span></span></b></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><b><br /></b></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span>Diagnosis </span></span><span style="font-family:Wingdings;mso-ascii-font-family: Corbel;mso-hansi-font-family:Corbel;mso-bidi-font-family:Corbel;mso-font-kerning: 12.0pt;mso-ansi-language:EN-US;mso-char-type:symbol;mso-symbol-font-family:Wingdings;"><span style="font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">à</span></span></span><span style="font-family:Corbel;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> usia kehamilan dan komplikasi yang ditemukan </span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span>Prognosis </span></span><span style="font-family:Wingdings;mso-ascii-font-family: Corbel;mso-hansi-font-family:Corbel;mso-bidi-font-family:Corbel;mso-font-kerning: 12.0pt;mso-ansi-language:EN-US;mso-char-type:symbol;mso-symbol-font-family:Wingdings;"><span style="font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">à</span></span></span><span style="font-family:Corbel;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> prediksi hasil taksiran persalinan, apakah lahir pervaginam atau </span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Corbel;mso-bidi- mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"> </span>kemungkinan seksio sesar. </span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span style="font-family:Corbel; mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language:EN-USfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span>Plan & treatme</span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">nt : perawatan yang diperlukan oleh ibu hamil</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size:large;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><b><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:x-large;"><span class="Apple-style-span" style="color:#000099;">Aktivitas selama hamil</span></span></span></b></p><span class="Apple-style-span" style="font-size:large;"> </span><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span>Boleh mengerjakan pekerjaan sehari-hari selama tidak memberikan gangguan.</span></span></p><span class="Apple-style-span" style="font-size:large;"> </span><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span>Aktivitas dibatasi bila didapatkan penyulit </span></span><span lang="IN" style=" font-family:Wingdings;mso-ascii-font-family:Corbel;mso-hansi-font-family:Corbel; mso-bidi-font-family:Corbel;mso-font-kerning:12.0pt;mso-char-type:symbol; mso-symbol-font-family:Wingdings;"><span style="font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">à</span></span></span><span lang="IN" style="font-family: Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> partus prematurus i</span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">mminens, <span class="Apple-tab-span" style="white-space:pre"> </span>ketuban pecah, </span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">menderita kelainan jantung.</span></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo3;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span>Coitus tidak dibolehkan bila:</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Ada perdara</span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">han vaginal</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Riwayat abortus </span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">berulang</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Abortus/partus prematurus imminens</span></span></p><span class="Apple-style-span" style="font-size:large;"> </span><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Ketuban pecah</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo4;mso-layout-grid-align:none; text-autospace:none"><span lang="EN-GB" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Serviks telah me</span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">mbuka</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size:large;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><b><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:x-large;"><span class="Apple-style-span" style="color:#3333FF;">Pakaian selama hamil</span></span></span></b><b><span lang="EN-GB" style="font-family: Corbel;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-GBfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span>Hindari palaian yang terlalu ketat </span></span><span lang="IN" style="font-family: Wingdings;mso-ascii-font-family:Corbel;mso-hansi-font-family:Corbel;mso-bidi-font-family: Corbel;mso-font-kerning:12.0pt;mso-char-type:symbol;mso-symbol-font-family:Wingdings;"><span style="font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">à</span></span></span><span lang="IN" style="font-family:Corbel;mso-bidi- mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> mengganggu aliran</span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> darah balik</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><span class="Apple-tab-span" style="white-space:pre"><span class="Apple-style-span" style="font-family:Georgia, serif;"> - </span></span>Sepatu hak tinggi akan m</span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">enambah lordosis sehingga sakit pinggang bertambah</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style=" white-space: pre;font-size:large;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><b><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:x-large;">Defekasi</span></span></b></p><span class="Apple-style-span" style="font-size:large;"> </span><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Defekasi menjadi tidak teratur karena:</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Pengaruh relaksasi otot polos oleh estrogen</span></span></p><span class="Apple-style-span" style="font-size:large;"> </span><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Tekanan uterus yang membesar</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Pada kehamilan la</span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">njut karena pengaruh tekanan kepala yang telah masuk panggul.</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Konstipasi dicegah dengan</span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">:</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Cukup banyak minum</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Olah raga</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="EN-GB" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Pemberia</span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">n laksatif ringan </span></span><span lang="IN" style="font-family:Wingdings; mso-ascii-font-family:Corbel;mso-hansi-font-family:Corbel;mso-bidi-font-family: Corbel;mso-font-kerning:12.0pt;mso-char-type:symbol;mso-symbol-font-family:Wingdings;"><span style="font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">à</span></span></span><span lang="IN" style="font-family:Corbel;mso-bidi- mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> jus buah-buahan</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-size:large;"><br /></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><b><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:x-large;">Obat-obat selama hamil</span></span></b><b><span lang="EN-GB" style="font-family: Corbel;mso-bidi-mso-font-kerning:12.0pt;mso-ansi-language: EN-GBfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></b></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Tahap paling kri</span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">tis dalam perkembangan janin </span></span><span lang="IN" style="font-family:Wingdings;mso-ascii-font-family:Corbel;mso-hansi-font-family: Corbel;mso-bidi-font-family:Corbel;mso-font-kerning:12.0pt;mso-char-type:symbol; mso-symbol-font-family:Wingdings;"><span style="font-family:Wingdings;"><span class="Apple-style-span" style="font-size:large;">à</span></span></span><span lang="IN" style="font-family: Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> minggu ke-2 hingga ke-8 pasca konsepsi (periode</span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> organogenesis)</span></span></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-list:l0 level1 lfo1;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Sifat teratogenik obat</span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"> ditentukan oleh:</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Cara kerja obat</span><span class="Apple-style-span" style="font-size:large;"><o:p></o:p></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Kemampuan obat mene</span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">mbus barrier plasenta</span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style="font-family:Wingdings;"><span><span class="Apple-style-span" style="font-size:large;">§</span><span style="font:7.0pt "Times New Roman""><span class="Apple-style-span" style="font-size:large;"> </span></span></span></span><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">Periode kri</span><span class="Apple-style-span" style=" ;font-family:Georgia, serif;"><span class="Apple-style-span" style=" ;font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;">tis perkembangan janin</span></span></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p><p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span class="Apple-style-span" style="font-family:Corbel;"><span class="Apple-style-span" style="font-size:large;"><br /></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:.8in;margin-bottom:.0001pt;text-align:left; text-indent:-.3in;mso-list:l0 level1 lfo6;mso-layout-grid-align:none; text-autospace:none"><span lang="IN" style=" font-family:Corbel;mso-bidi-mso-font-kerning:12.0ptfont-family:Corbel;font-size:28.0pt;"><span class="Apple-style-span" style=" ;font-family:Georgia, serif;font-size:16px;"><span class="Apple-style-span" style=" ;font-family:Corbel;font-size:-webkit-xxx-large;"><span class="Apple-style-span" style=" ;font-family:Georgia, serif;font-size:16px;"> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhU895imxkM-ctRaHQW4WdPR7QIQMfDG_MMqJTrgpdjSEGxYKnIvdk4RGq958oatbCQgwFYFWOc8AqOApHYsP4IujukVQglzBsdMOqMgAzerer9EVeX40ZCXIG26oJGx4bUWf5eMtw25Z2f/s200/hamil.jpg" style="cursor:pointer; cursor:hand;width: 174px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5411999730067819650" /></span></span></span></span></p> <p class="MsoNormal" align="left" style="margin-top:0in;margin-right:0in; margin-bottom:0in;margin-left:34.55pt;margin-bottom:.0001pt;text-align:left; text-indent:-.35in;mso-layout-grid-align:none;text-autospace:none"><span lang="IN" style="font-family:Corbel;mso-bidi- mso-font-kerning:12.0ptfont-family:Corbel;font-size:32.0pt;"><o:p> </o:p></span></p> <p class="MsoNormal"><span lang="IN"><o:p> </o:p></span></p></div>DEVIANAhttp://www.blogger.com/profile/01031644635327768252noreply@blogger.com0tag:blogger.com,1999:blog-6730807132725239761.post-87077581226429622302009-12-05T09:19:00.000-08:002009-12-05T10:28:46.262-08:00KELAINAN KONGENITAL PADA TRAKTUS GINETALIA WANITA<div style="text-align: center;"><br /></div><div style="text-align: left;"><span class="Apple-style-span" style="font-weight: bold; ">VULVAANOMALI PADA VULVA DAN LABIA</span></div><div><b><br /></b></div><div><b>Duplikasi vulva</b><span class="Apple-tab-span" style="white-space:pre"> </span></div><div><span class="Apple-tab-span" style="white-space:pre"></span><i><span class="Apple-tab-span" style="white-space:pre"> </span>Merupakan suatu keadaan yang jarang dite<span class="Apple-style-span" style="font-style: normal; "><i>mukan dan sering bersama-sama dengan </i><span class="Apple-tab-span" style="white-space:pre"><i> </i></span><i>duplikasi traktus urinaria dan trak<span class="Apple-style-span" style="font-style: normal; "><i>tus intestinal</i></span></i></span></i></div><div><b><br /></b></div><div><i><span class="Apple-style-span" style="font-style: normal; "><i></i><b>Hipertrofi labia minora</b></span></i></div><div><ul><li><span class="Apple-style-span" style="font-style: italic; ">Ukuran dan bentuk labia minora bervariasi</span></li><li><i>Salah satu labia minora dapat lebih besar</i></li><li><i>Pasien harus diyakinkan bahwa ukuran yang tidak simetri hanya merupakan suatu variasi, tidak perlu diterapi, kecuali jika perbedaan ukuran tersebut sangat jelas mengganggu saat berhubungan</i></li></ul><span class="Apple-style-span" style="font-size:large;"><div><br /></div>VAGINA</span></div><div><b><br /></b></div><div><b>HIMEN IMPERFORATA</b></div><div><div style="text-align: center;"><b><br /></b></div><b><div style="text-align: center;"><br /></div><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgw9dkxs7G_ecY5DKI2Rnc0ekzpDyFZH1xf71LcI6rFN7uEXrAUAFa4qveqvRFnUd5Abeyx3PNLxuIbDFNn-_xZ1JmDInGDm3tXCVm2-jWitlnw4xpP4E_CroiwLHS2hy9LMQ1RfG0893AC/s200/Picture1.png" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 200px; height: 135px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5411807399356018450" /></b><ul><li><i>Pada gadis, vagina tertutup lapisan tipis bermukosa <span class="Apple-tab-span" style="white-space:pre"> <span class="Apple-tab-span" style="white-space:pre"> </span>: </span></i><span class="Apple-style-span" style="color:#FF0000;"><i>selaput dara / hymen</i></span></li><li><i>Hymen normal terdapat lubang kecil untuk aliran darah menstruasi</i></li><li><i>Akibat coitus atau trauma lain, hymen robek & menjadi tidak beraturan</i></li><li><i><span class="Apple-style-span" style="color:#FF0000;"><b>Hymen imperforata</b></span> : tidak terdapat lubang</i></li><li><i>Merupakan kelainan kongintal yang paling banyak ditemukan</i></li><li><i>Biasanya diagnosis ditegakkan setelah usia dewasa</i></li><li><i>Geja</i>la : <i>amneorea primer, nyeri abdomen siklik, bulging hymen</i></li><li><i>Menyebabkan hematokolpos, hematometra</i></li><li><i>Penanganan : pembedahan</i></li></ul><div style="text-align: center;"><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiQTSmqfob93htMGR8G2nIoIUppnN4PxG-6gr_bx_dQFW9KZHGTYgDW9ywx7YYH5LpW7S9qRicF4ypfdSRlo-AhAaV4kV1HJzhOpMoNGjgOl43NaRIacpyzxgCbUuNED76ggbmPVFhIbWQc/s200/Picture2.png" style="cursor:pointer; cursor:hand;width: 182px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5411812963165306178" /></div><div style="text-align: center;"><br /></div><b>SEPTUM VAGINA</b></div><div><ul><li><span class="Apple-style-span" style="font-style: italic; ">Terdapat sekat pada vagina</span></li><li><i>Dapat transversal maupun longitudinal</i></li><li><i>Dapat di daerah mana saja di vagina</i></li><li><i>Tetap ditemukan lubang vagina. Labium intak dan terpisah</i></li><li><i>Pada anak-anak : kadang-kadang asimptomatik</i></li><li><i>Keluhan baru dirasaakan saat mendapat haid</i></li></ul><div style="text-align: center;"><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg3V2JMOgG-5EtQU8Kq-eWiZuqXpfEcKXxa1H5GGPRan6O3gAoBpjo2CcnD9qj7KKuBMVs7MPouZVYYA7vDgRvNroGjk40RpqNb5sFmNc1e7TsuVExwrSzde-IrZc_rpl-GfJLRtxLzxqKO/s200/Picture3.png" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 198px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5411815261718916098" /></div><b>ATRESIA VAGINA</b><ul><li><i>Curiga bila tidak ditemukan lubang vagina</i></li><li><i>Kadang-kadang terdapat lubang vagina tetapi dangkal</i></li><li><i>Disebabkan karena kegagalan pembentukan daerah vagina bagian inferior</i></li><li><i>Labia tetap intak, vagina bgn atas, serviks dan uterus tetap normal</i></li><li><i>Pemeriksaan : palpasi vagina yang alami distended pada RT</i></li><li><i>Perlu pemeriksaan USG, MRI</i></li><li><i>Terapi : Pembedahan</i></li></ul><b>ANOMALI UTERUS</b></div><div><i><br /></i></div><div><b><span class="Apple-style-span" style="font-weight: normal; font-style: italic; ">Umumnya asimptomatik sehingga sulit didiagnosis sewaktu masa kanak-kanak</span></b><ul><li><i>Keluhan biasanya mulai ditemukan saat menars atau saat berhubungan dengan kehamilan</i></li><li><i>Duplikasi uterus dapat tejadi hanya pada korpus uteri dan serviks dan vagina</i></li><li><i>Uterus bidelfis sering dihubungkan dengan persalinan prematur</i></li><li><i>Saat kehamilan sering mengalami abortus, kelainan presentasi dan prematur</i></li><li><i>Uterus unikornu disebabkan karena gangguan perkembangan dari duktus mullerian</i></li><li><i>Uterus unikornu seringkali asimptomatik</i></li><li><i>Uterus rudimenter : darah dapat terkumpul di uterus yang rudimenter sehingga kadang-kadang membutuhkan tindakan pembedahan emergensi, utamanya bila tidak ada saluran yang menghubungkan dengan uterus yang normal atau vagina</i></li><li><i>Bila terjadi kehamilan pada uterus yang rudimenter dapat terjadi ruptur</i></li></ul><br /><br /><br /><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEitV9gDM-pEJTktmGzlrkDQVXX9sjegax39SZ3ywH8gduoAmcmVYnEmyXeVcF2JzSQ4lnIZMUyTyy1lcV5HvKej-JOoXfOrmUhYKXi6dkV0QczAHBaedSiLjNPwqEjKwXxrHs6V9aEig0Lj/s200/Picture4.png" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 200px; height: 79px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5411809077265001762" /><br /> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhrQw1bpe9ntymi17rNSqO0-5yYeAdPcVPTXQ2-rie6JEhua27Odeia6J87v5enSey9Zb4cG2YrbZNXo3aj7K2AAbgwFroa0ua0sYVH57d1ORnUsFIRpTOFkvPaie9muedLCv9jIXat7OQP/s200/Picture5.jpg" style="cursor:pointer; cursor:hand;width: 176px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5411812970817201586" /><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhW75LaGzgaYP0IT5BEcxFZdhqKL-K-NcPWuTbwqpXkhrdW-0t94h4JtZtqP626bPYWX6yh91h9DvlPgTUJrrWb54n9-eNM-2dnvaMdoMTJEqXPHb3UEjjLddHS9xykZYh2t2bsgngQvOCt/s200/Picture8.jpg" style="cursor:pointer; cursor:hand;width: 182px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5411812984442037522" /> <img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjrh65SBunMOaR3dpAbLQGXtHBpLXAd82VqZsOzyHL9YorUs9SdJ2EUvxgTg_1V6T4WNjw97pQKWTBTai__CXF5okTtWl_J9untAdP5xxTqltqEPQKeQuyfA_sxp6x7djmc-lNkpqbgSNz5/s200/Picture6.jpg" style="cursor:pointer; cursor:hand;width: 151px; height: 200px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5411812975140640370" /></div><div><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEikIsVJiGOgj02vQk-szj08VPMMMUoThicKrwDb4uah3zytr535xaDdp_B46jaoQlasFa8nzw1G3H8kWMegYGdUvSvAyuHvNNMy6-IcZN4LjisVQ5WuQgzikMk4R4sDSGPwGBd8AriPoLY4/s200/Picture7.gif" style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 200px; height: 130px;" border="0" alt="" id="BLOGGER_PHOTO_ID_5411809088211839154" /><b>OVARIUM</b><br /><ul><li><i>Dapat berupa tidak ada ovarium, salah satu atau keduanya.</i></li><li><i>Jarang ditemukan</i></li><li><i>Ovarium tambahan</i></li></ul><br /><b>SISTEM GENITAL DAN TRAKTUS URINARIUS</b><br /><ul><li><i>Dalam pertumbuhannya mempunyai hubungan yang dekat sehingga dapat terjadi kelainan dalam pertumbuhannya yang dapat mengenai kedua sistem tersebut</i></li><li><i>Kloaka persistem : tidak terbentuk septum urorektale</i></li><li><i>Ekstrofi kandung kencing :vagina terdorong ke depan di daerah suprapubik dan klitoris terbagi dua karena dinding perut bagian bawah tidak terbentuk</i></li></ul><b>KELAINAN KONGENITAL KARENA KELAINAN KROMOSOM</b><br /><ul><li><span class="Apple-style-span" style="font-style: italic; ">Sebagian besar karena kelainan kromosom seks</span></li><li><span class="Apple-style-span" style="font-style: italic; ">Kelainan kromosom autosom jarang</span></li></ul><br /><b>SINDROM TURNER (DISGENESIS GONAD)</b><br /><ul><li><i>Tidak jarang ditemukan</i></li><li><i>Tidak ditemukan sel-sel kelamin primordial</i></li><li><i>Tidak ada pertumbuhan korteks atau medulla pada gonad</i></li><li><i>Gonad hanya dijumpai sebagai suatu jaringan ikat putih seperti pita (streak gonad)</i></li><li><i>Fisik : bertubuh pendek ( <></i></li><i><li><i>Amenorea primer</i></li><li><i>Pterigium kolli (webbed neck)</i></li><li><i>Nevus banyak ditemukan</i></li><li><i>Koarktasi aorta</i></li><li><i>Kubitus valgus</i></li><li><i>Ciri-ciri kelamin sekunder tidak tumbuh</i></li><li><i>Kecerdasan normal</i></li><li><i>Pemeriksaan endokrinologi : kadar FSH meningkat dan kadar estrogen rendah karena tidakadanya ovarium</i></li><li><i>Kelainan genetik : satu kromosom X, sehingga susunannya : 44 otosom dan i kromosom X (45-XO)</i></li><li><i>Pada pemeriksaanbuccal smear : kromatin X negatif</i></li><li><i>60-80% : 45 – XO, 20 – 40% 46 – XX dengan 1 X tidak normal, atau tipe mosaik XO/XX</i></li><li><i>Pengelolaan :</i></li><li><i>Biasanya sejak kecil diasuh sebagai wanita teruskan</i></li><li><i>Pemberian estrogen secara siklik untuk menimbulkan withdrawal bleeding, mempengaruhi pembesaran mammae, tubuh lebih menyerupai wanita dan secara mental lebih puas dan tenang </i></li></i></ul><i><br /><b>SUPERFEMALE (47,XXX)</b><br /><ul><li><i>1 : 1000 kelahiran bayi wanita</i></li><li><i>Disebabkan karena non-dysjunction</i></li><li><i>Penampilan : wanita biasa, perkembangan seks normal, subur hanya kecerdasannya rendah.</i></li><li><i>Dengan kariotipe 47,XXX dapat ditemukan 2 kromatin X</i></li></ul><br /><b>SINDROM KLEINEFELTER (47,XXX)</b><br /><ul><li><i>Ditemukan pada penderita dengan fenotipe pria</i></li><li><i>Tumbuh sebagaia pria, pada masa pubertas tumbuh ginekomasti</i></li><li><i>Badanberbentuk eneukhoid dan rambut badan dan muka berkurang</i></li><li><i>Genitalia eksterna berkembang baik</i></li><li><i>Fungsi seksual juga baik</i></li><li><i>Testis atrofi, azospermia, dan pada biopsi testis ditemukan sel-sel leydig dan hialinisasi tubulus seminiferus</i></li><li><i>Terjadi sebagai akitab nondisjunction</i></li></ul><br /><b>HERMAFRODITISMUS VERUS</b><br /><ul><li><i>Jarang ditemukan</i></li><li><i>Genitalia eksterna tampak dominasi pria sehingga seringkali diasuh sebagai pria, tetapi bila ditemukan secara dini, maka sebaiknya anak diasuh sebagai wanita</i></li><li><i>Masa pubertas : mamma mulai tumbuh dan seringkali terjadi haid</i></li><li><i>Terdapat jaringan testis pada sisi yang satudan ovarium pada sisi lain</i></li><li><i>Sebagian besar menunjukan kromatin seks dan gambaran karitipe wanita</i></li><li><i>Prinsip penanganan : pola asuh dari kecil dipertahankan. Cenderung untuk mengangkat testis karena cenderung menjadi ganas</i></li></ul><br /><b>SINDROMA DOWN</b><br /><ul><li><i>1 :670 kelahiran hidup</i></li><li><i>Kelainan kromosom otosom</i></li><li><i>Terutama dialami oleh ibu usia tua</i></li><li><i>Terjadi tranlokasi kromosom 21, biasanya dari kromosom D</i></li><li><i>Kecerdasan rendah</i></li><li><i>Mulut terbuka dengan lidah yang menonjol. Oksiput dan muka gepeng</i></li><li><i>Hipotoni tubuh yang jelas</i></li><li><i>Refleks moro negatif</i></li></ul><br /><b>SINDROM EDWARDS (TRISOMI 18)</b><br /><ul><li><i>JARANG DITEMUKAN</i></li><li><i>Pertumbuhan anak lambat</i></li><li><i>Kepala memanjang dengan kelainan pada telinga</i></li><li><i>Sering disertai kelainan jantung</i></li><li><i>Dada dengan sternum pendek</i></li></ul><br /><br /><b>SINDROM PATAU (TRISOMI 13)</b><br /><ul><li><span class="Apple-style-span" style="font-style: italic; ">Jarang ditemukan</span></li><li><span class="Apple-style-span" style="font-style: italic; ">BBLR</span></li><li><span class="Apple-style-span" style="font-style: italic; ">Pertumbuhan lambat</span></li><li><span class="Apple-style-span" style="font-style: italic; ">Palatoskisis, labioskisis</span></li><li><span class="Apple-style-span" style="font-style: italic; ">Mikrosefal, polidaktili</span></li><li><span class="Apple-style-span" style="font-style: italic; ">Sering ditemukan kelainan jantung</span></li></ul><br /><b><span class="Apple-style-span" style="font-size:large;">KELAINAN KONGENITAL AKIBAT HORMONAL</span></b><br /><br /><b>MASKULINISASI PADA WANITA DENGAN KROMOSOM DAN GONAD WANITA</b><br /><ul><li><i>Sindrom adrenogenital kongenital : sering ditemukan</i></li><li><i>Pengaruh virilisasi pleh androgen akibat gangguan metabolisme pada kelenjar adrenal</i></li><li><i>Kedua kelenjar adrenal membesar : hiperplasia dari zona retikularis, sedang zona glomerulosa kurang berkembang</i></li><li><i>Ovarium : folikel normal, tetapi bila tidak diobati aktivitas folikel mundur dan folikel primordial menghilang</i></li><li><i>Gangguan terletak pada biosintesis kortisol sehingga umpan balik tidak jalan</i></li><li><i>Gambaran klinik :</i></li></ul><i><span class="Apple-tab-span" style="white-space:pre"> </span>Waktu lahir : lipatan labium mayus kiri dan kana menjadi satu, klitoris membesar<br /><span class="Apple-tab-span" style="white-space:pre"> </span>Di dalam lipatan yang menjadi skrotum tidak ada kelenjar kelamin<br /><span class="Apple-tab-span" style="white-space:pre"> </span>Uterus, tuba dan ovarium normal<br /><span class="Apple-tab-span" style="white-space:pre"> </span>Anak dapat tumbuh dengan cepat, tetapi pada umur 10 thn, epifisis menutup, <span class="Apple-tab-span" style="white-space:pre"> </span>pertumbuhan berhenti, sehingga cenderung pendek<br /><span class="Apple-tab-span" style="white-space:pre"> </span>Rambut pubis dan ketiak tumbuh cepat, tidak haid<br /><span class="Apple-tab-span" style="white-space:pre"> </span>Untuk menegakkan diagnosis :<br /><span class="Apple-tab-span" style="white-space:pre"> </span>Kadar 17 ketosteroid dalam urin meningkat<br /><span class="Apple-tab-span" style="white-space:pre"> </span>Kadar pregnanetriol urin meningkat<br /><span class="Apple-tab-span" style="white-space:pre"> </span>Gangguan keseimbangan elektrolit, turunnya natrium di serum<br /><span class="Apple-tab-span" style="white-space:pre"> </span>Kromosom seks positif<br /><span class="Apple-tab-span" style="white-space:pre"> </span>Gambaran kromosom 46,XX</i><br /><ul><li><i>Penanganan :</i></li></ul><span class="Apple-tab-span" style="white-space:pre"><i> </i></span><i>kortikosteroid<br /><br /></i><br /><br /><b>SINDROM FEMINISASI TESTIKULER</b><br /><ul><li><i>Genotip pria dan fenotip wanita</i></li><li><i>Genitalia eksterna seperti wanita</i></li><li><i>Sering ditemukan dalam suatu keluarga</i></li><li><i>Gangguan metabolisme endokrin</i></li><li><i>Tidak ditemukan kelainan kromosom</i></li><li><i>Klinis : ciri khas wanita, tetapi tidak mempunyai genitalia interna wanita, terdapat testis yang kurang tumbuh dan ditemukan di rongga abdomen, di kalais inguinalis atau di labium mayus</i></li><li><i>Testis tidak menunjukkan spermatogenesis</i></li><li><i>Mempunyai wajah wanita, tinggi, pertumbuhan mamma baik</i></li><li><i>Rambut pubis dan ketiak kurang atau tidak ada</i></li><li><i>Genitalia eksterna ada, tetapi vagina pendek atau menutup</i></li></ul><br /><span class="Apple-style-span" style="font-size:large;"><b>PENGELOLAAN INTERSEKS</b></span><br /><ul><li><i>Tentukan morfologi alat genitalia eksterna dan ke arah mana berkembangnya</i></li><li><i>Pemeriksaan kromatin pada anak kecil tidak terlalu diperlukan</i></li><li><i>Pengobatan hormonal saat dewasa</i></li><li><i>Pembedahan</i></li><li><i>Pengarahan mental</i></li></ul><div style="text-align: right;"><br /></div><br /></i></div><i></i>DEVIANAhttp://www.blogger.com/profile/01031644635327768252noreply@blogger.com1