Seksio Sesaria (SC) dan Total Abdominal Hysterektomi-Bisalphingo Ooforektomi (TAH-BSO) pada Kehamilan dengan Kistoma Ovarii Permagna

A woman 28 years with G1P0A0, 33 weeks pregnancy with Prominent Ovarian Cystoma who underwent SC procedure and TAH-BSO. Preoperative assessment showed that the patient was in optimal condition. Procedure of anesthesia with intubation techniques ET GA no 7 controlled breath was performed. Monitoring is done with NIBP, ECG, Oxygen Saturation (SpO2) and CVP. The operation lasted 4 hours. Durante operation, the blood pressure decreased when cystoma were removed and hysterectomy was caused by massive bleeding. Fluid resuscitation were administered with crystalloid fluids, colloids, blood and drug delivery support norepinephrine and titration dobutamine. After the surgery, the ET still attached and the patient was transported to the ICU. Twenty four hours after the first surgery, laparatomy operation was performed to explore the possibility of rebleeding in the stomach and to remove the abdomen tampon. Nine days of treatment in the ICU, the patient was transferred to the reguler ward.

Seorang perempuan usia 28 tahun G1P0A0, hamil 33 minggu dengan Kistoma Ovarii Permagna yang menjalani operasi SC dan TAH-BSO. Penilaian preoperasi pasien sudah dalam kondisi yang optimal. Dilakukan anestesi dengan teknik General anesthesia (GA) Intubasi Endotracheal Tube (ET) no. 7 nafas kendali. Monitoring dilakukan dengan Non invasive blood pressure (NIBP), elektrokardiogram (EKG), saturasi oksigen perifer (SpO2) dan Central Venous Pressure (CVP). Operasi berlangsung selama ± 4 jam. Durante operasi terjadi penurunan tekanan darah saat dilakukan pengangkatan kistoma dan histerektomi disebabkan oleh perdarahan masif. Dilakukan resusitasi dengan pemberian cairan kristaloid, koloid, darah dan pemberian support obat norepinefrin dan dobutamin titrasi. Pasca operasi masih terpasang ET no.7 dan ditransport ke ICU. Dua puluh empat jam pasca operasi dilakukan operasi laparatomi ulang untuk mengeksplorasi kemungkinan perdarahan intraabdomen dan untuk melepas tampon abdomen. Setelah 9 hari perawatan di ICU pasien dipindah ke bangsal.