DAFTAR ISI

DAFTAR ISI ....................................................................................................... i

BAB I
PENDAHULUAN................................................................................................ 1

BAB II
TINJAUAN PUSTAKA....................................................................................... 2
2.1 Preeklamsia Berat..................................................................................... 2
2.1.1 Definisi............................................................................................. 2
2.1.2 Epidemiologi................................................................................... 3
2.1.3 Etiologi............................................................................................. 3
2.1.4 Klasifikasi........................................................................................ 4
Penjelasan Pembagian Klasifikasi.................................................... 4
Pembagian Preeklampsia Berat........................................................ 4
Penjelasan Tambahan....................................................................... 5
2.1.5 Patofisiologi..................................................................................... 5
1. Teori kelainan vaskularisasi plasenta........................................... 5
2. Teori Iskemia Plasenta, Radikal Bebas,
dan Disfungsi Endotel.................................................................. 6
2.1 Iskemia plasenta dan pembentukan oksidan
/radikal bebas.......................................................................... 6
2.2 Peroksida lemak sebagia oksidan pada hipertensi
Dalam kehamilan................................................................... 7
2.3 Disfungsi Sel Endotel............................................................ 7
3. Teori Intoleransi Imunologik antara Ibu dan Janin....................... 8
4. Teori Adaptasi Kardiovaskular..................................................... 9
5. Teori Genetik................................................................................ 10
6. Teori Defisiensi Gizi ( Teori Diet )............................................... 10
7. Teori Stimulus Inflamasi............................................................. 11
2.1.6 Perubahan Sistem dan Organ pada Preeklamsia........................ 12
1. Volume Plasma............................................................................ 12
2. Hipertensi.................................................................................... 12
3. Fungsi Ginjal............................................................................... 13
3.1 Perubahan fungsi ginjal........................................................ 13
3.2 Proteinuria............................................................................ 13
3.3 Asam Urat Serum................................................................. 14

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 3.4 Kreatinin............................................................................... 14
3.5 Oliguria dan Anuria.............................................................. 14
4. Elektrolit..................................................................................... 15
5. Tekanan Osmotik Koloid Plasma / Tekanan Onkotik................. 15
6. Koagulasi dan Fibrinolisis.......................................................... 15
7. Viskositas Darah......................................................................... 15
8. Hematokrit.................................................................................. 16
9. Edema......................................................................................... 16
10. Hematologik............................................................................... 16
11. Hepar.......................................................................................... 16
12. Neurologi.................................................................................... 17
13. Kardiovaskular........................................................................... 17
14. Paru............................................................................................. 17
15. Janin............................................................................................ 18
2.1.7 Diagnosis.......................................................................................... 18
1. Preeklampsia Ringan................................................................... 18
2. Preeklampsia Berat...................................................................... 18
3. Eklampsia.................................................................................... 19
2.1.8 Diagnosis Banding.......................................................................... 19
2.1.9 Tatalaksana..................................................................................... 21
1. Preeklampsia Ringan................................................................... 21
1.1 Manajemen Umum Preeklampsia Ringan............................ 21
1.2 Tujuan Utama Perawatan Preeklampsia............................... 21
1.3 Rawat Jalan ( Ambulatoir )................................................... 21
1.4 Rawat Inap ( Dirawat di rumah sakit ) ................................ 22
1.5 Perawatan Obstetrik yaitu sikap terhadap kehamilannya..... 22
2. Preeklampsia Berat...................................................................... 23
2.1 Perawatan dan Pengobatan Preeklampsia Berat................... 23
2.2 Monitoring selama di rumah sakit........................................ 23
2.3 Manajemen umum perawatan Preeklampsia berat............... 23
2.4 Sikap terhadap penyakit : Pengobatan Medikamentosa....... 23
2.4.1 Pemberian obat antikejang......................................... 24
2.4.2 Diuretikum................................................................. 26
2.4.3 Pemberian antihipertensi............................................ 26
2.4.4 Edema paru................................................................ 27

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 2.4.5 Glukokortikoid........................................................... 28

3. Eklampsia.................................................................................... 28
3.1 Perawatan Eklampsia........................................................... 28
3.2 Pengobatan medikamentosa................................................. 28
3.2.1 Obat antikejang........................................................... 28
3.2.2 Magnesium sulfat (MgSO4)........................................ 29
3.2.3 Perawatan pada waktu kejang..................................... 29
3.2.4 Perwatan koma............................................................ 29
3.2.5 Perawatan paru............................................................ 30
3.3 Pengobatan Obstetrik........................................................... 30
2.1.10 Komplikasi................................................................................... 31
2.1.11 Prognosis...................................................................................... 31
2.2 Sindroma HELLP..................................................................................... 32
2.2.1 Definisi Klinik.............................................................................. 32
2.2.2 Diagnosis....................................................................................... 32
2.2.3 Terapi Medikamentosa............................................................... 32
2.2.4 Sikap Pengelolaan Obstetrik...................................................... 33
2.2.5 Sikap Terhadap Kehamilan........................................................ 33
2.2.6 Pengelolaan.................................................................................. 33

DAFTAR PUSTAKA........................................................................................... 35

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