PENDEKATAN DIAGNOSIS PLASENTA AKRETA : LAPORAN KASUS
DOI:
https://doi.org/10.31004/prepotif.v8i3.31833Keywords:
Pendekatan Diagnosis, Plasenta Akreta, Plasenta Letak Rendah, Spektrum Plasenta AkretaAbstract
Plasenta akreta spektrum (PAS) merupakan suatu kondisi terjadinya abonrmalitas perlekatan plasenta dimana trofoblas melakukan invasi (sebagian ataupun seluruhnya) secara abnormal ke dalam miometrium uterus merupakan suatu kondisi seseorang mengalami plasenta akreta. Kerusakan apapun yang terjadi sebelumnya pada endometrium merupakan faktor risiko terjadinya PAS, riwayat persalinan sesar sebelumnya merupakan faktor risiko terumum. Angka kematian akibat PAS diperkirakan mencapai 7%. Angka tersebut dipengaruhi oleh berbagai hal seperti kurangnya pengalaman tenaga kesehatan akan pendekatan diagnosis plasenta akreta dan teknik bedah yang tidak memadai sehingga menyebabkan perdarahan hebat dan kematian. Pentingnya pendekatan diagnosis plasenta akreta meliputi anamesis, pemeriksaan fisik serta pemeriksaan penunjang seperti pencitraan. Telah disajikan kasus plasenta akreta dengan riwayat tindakan kuretase setahun sebelumnya dalam laporan kasus ini pada pasien berusia 39 tahun G7P4A2, usia kehamilan 36 minggu mengeluhkan keluar darah dari jalan lahir sejak 20 jam lalu disertai rasa mulas. Pemeriksaan abdomen didapatkan striae, linea nigra, TFU 28 cm, kontraksi 3x/10 menit. Pemeriksaan leopold didapatkan janin tunggal, hidup, intrauterine, presentasi kepala, letak membujur dengan punggung di sebelah kanan, dan kepala belum masuk pintu atas panggul. Detak jantung janin 130x/menit. Pemeriksaan laboratorium didapatkan leukositosis. Hasil USG obstetri menunjukkan gambaran plasenta letak rendah dan tali pusat terkemuka. Didapatkan diagnosa plasenta akreta setelah pasien dilakukan tindakan sectio caesarea diikuti dengan histerektomiReferences
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