Penatalaksanaan Anestesi pada Operasi Seksio Caesarea Pasien G4p3a0 dengan Trombositopenia, Presentasi Bokong Murni dan Bayi Besar - prabandari, dita; Erlangga, M. Erias (Perdatin Pusat, 2014)
Trombositopenia adalah penurunan jumlah trombosit dibawah normal. Umumnya terjadi pada 7 ̶ 8% kehamilan. Trombositopenia dapat terjadi pada beberapa kondisi, beberapa diantaranya adalah kehamilan. Trombositopenia merupakan kelainan hemotologis umum kedua setelah anemia pada kehamilan. Perdarahan pada kasus obstetri berperan besar terhadap kematian ibu, yaitu sekitar 127.000 kematian setiap tahun di dunia. Perdarahan post partum merupakan mayoritas penyebabnya dan penyebab umum dari perdarahan post partum adalah gangguan koagulasi dan koagulopati. Seorang wanita, G4P3A0 parturien aterm kala I fase aktif, trombositopenia, presentasi bokong murni, TBBJ >3.500 gr direncanakan seksio caesarea (SC). Hasil laboratorium didapatkan Trombosit 7.000 mm3. Pemeriksaan didapatkan ekimosis di keempat extremitas. Penatalaksanaan anestesi pada pasien ini dilakukan dalam anestesi umum. Kondisi pasien pasca operasi, tidak didapatkan defisit neurologis maupun perdarahan aktif. Setelah diobservasi di ruang pemulihan, pasien dipindahkan ke ruang perawatan. Kata kunci: Kehamilan, seksio caesaria, trombositopenia Trombositopenia is a term of decrease in platelet count below normal value. 7 ̶ 8% happens in pregnancy. Trombositopenia can happen in several conditions, one of them was pregnancy. Trombositopenia is a hemotologic disorder that commonly happen secondary after anemia in pregnancy. Hemorrhage in obstetri cases play major role in mother’s death, around 127,000 mother died each year. Post partum hemorrhage is the major cause and the general cause of post partum hemorrhage was coagulation disorder and coagulopathy. A woman G4P3A0 in parturient at term phase I, trombositopenia, frank breech presentation, prediction baby body weight >3500 plan for cesarian section (c-section). The lab result shows platelet count 7000 mm3. From physical examination shows echimosis in both extremity. We performed the c-section in general anesthesia. Post operative condition, no sign of defisit neurologis nor active bleeding. After close monitoring in the recovery room, the patient then transferred to regular ward. Key words: C-seksion, pregnancy, trombositopenia Reference Anestesi obstetri, Bisri T, Wahjoeningsih S, Suwondo B. Anestesi Obstetri; komisi pendidikan spesialis anestesiologi konsultan anestesi obstetri kolegium anestesiologi dan terapi intensif Indonesia. 2013. Grensheimer T, James A, Stasi R. How I treat trombositopenia in pregnancy, journal of the American society of hematology, nov 2012 Thompson SA, Liew ACS, Kam P.C.A. Anesthesia university of St. George Hospital, Australia, 2004, 59, pages 255–264 Butterworth John F., Mackey David C. Morgan and Mikhail’s clinical anesthesiology maternal and fetal physiologi and anesthesiology: Newyork;McGraw Hill, 2013. Chestnut David H. Obstetri anesthesia principles and practice 3rd edition. Elseveir mosby: Philadeplphia; 2004. Bravemen Ferne R. Obstetri and gynecologic anesthesia the requisites in anesthesiology, Mosby. Philadelphia, 2006. Sanjay D, Bhavani S,Scott S. Obstetri anesthesia handbook. 5th edition, springer New York, 2006. The American Society of Anesthesiologist. Practice guidelines for obstetri anesthesia, an updated report by the American society of anesthesiologist task force on obstetri anesthesia, anesthesiology, lippincott wiliams and wilkins, inc;2007;106:843–63. Lyons Gordon, Platelet Counts and Obstetric Analgesia and Anaesthesia, National Blood Transfusion Committee, London Simon L, Santi TM, Sacquin P, Hamza J., Pre-anaesthetic assessment of coagulation abnormalities in obstetric patiens: usefulness, tiing and clinical implication; BJA 1997;78;678–683 Gemsheimer T., James H. Andra, Stasi R., How I Treat Thrombocytopenia in Pregnancy. United Kingdom. Blood. 2013;121(1); 38