SKENARIO C BLOK 24

A male baby was born at type C public Hospital from a 41 years old woman. Her mother, Mrs.
Anita was hospitalized at the Hospital due to uterine contraction. It was her third pregnancy. She
forgot when her first day of last period, but she thought that her pregnancy was about 7 months.
Her other children were born preterm too, about 8 months. Now they are 4 years old and 2 years
old.
Four hours after admitted, she deliver her baby spontaneously. The labor process was 30 minutes,
and ruptured of membrane was one hour before delivery. The liquor was clear. The baby was not
cried spontaneously after birth, but grunting and his whole body was cyanosis. Pediatrics
residence who resuscitate the baby did first step of resuscitation to the baby. APGAR score at
first minute was 3 and fifth minutes was 7.
On physical examination:
Body weight was 1350 grams, body length was 41cms, and head circumference was 31 cm. the
muscle tone was decreased, he was poorly flexed at the limbs, he has thin skin, more lanugo over
the body and plantar plantar creases 1/3 anterior. At 10 minutes of age, his still had grunting and
cyanosis of the whole body, respiratory rate was 86 breaths per minute, there were epigastric
retraction, breathing sound decreased. Heart rate 156 beats per minute. Saturation 85% with
nasal oxygen.

I. Klarifikasi Istilah
Rumah sakit tipe C

: rumah sakit yang mampu memberikan pelayan kedokteran, sub

APGAR score

pernapasan dan berhentinya jantung.

: sebuah pengukuran respon bayi terhadap kelahiran dan
kehidupan di luar rahim, didasarkan pada penampilan, denyut
jantung, refleks, kegiatan, dan pernapasan. Penilaian diambil

Lanugo

pada 1 dan 5 menit setelah kelahiran berkisar antara 1-10.

: rambut halus dan tipis yang muncul pada kulit janin yang

Plantar creases
Retraksi epigastrik
Saturasi oksigen

sering muncul pada bayi prematur.

: garis atau cekungan pada telapak kaki yang kurang lebih linear.
: tertariknya otot-otot epigastrium.
: fraksi hemoglobin yang tersaturasi oksigen relatif terhadap
hemoglobin total.

II. Identifikasi Masalah

1. A male baby was born at type C public Hospital from a 41 years old woman. Her
mother, Mrs. Anita was hospitalized at the Hospital due to uterine contraction.
2. It was her third pregnancy. She forgot when her first day of last period, but she thought
that her pregnancy was about 7 months. Her other children were born preterm too, about
8 months. Now they are 4 years old and 2 years old.
3. Four hours after admitted, she deliver her baby spontaneously. The labor process was 30
minutes, and ruptured of membrane was one hour before delivery. The liquor was clear.

4. The baby was not cried spontaneously after birth, but grunting and his whole body
was cyanosis.
5. Pediatrics residence who resuscitate the baby did first step of resuscitation to the baby.
APGAR score at first minute was 3 and fifth minutes was 7.
6. On physical examination:
Body weight was 1350 grams, body length was 41cms, and head circumference was 31
cm. the muscle tone was decreased, he was poorly flexed at the limbs, he has thin skin,
more lanugo over the body and plantar creases 1/3 anterior. At 10 minutes of age, his
still had grunting and cyanosis of the whole body, respiratory rate was 86 breaths per
minute, there were epigastric retraction, breathing sound decreased. Heart rate 156 beats
per minute. Saturation 85% with nasal oxygen.

III.

Analisis Masalah
1. A male baby was born at type C public Hospital from a 41 years old woman. Her
mother, Mrs. Anita was hospitalized at the Hospital due to uterine contraction. It was
her third pregnancy. Her other children were born preterm too, about 8 months. Now
they are 4 years old and 2 years old.
a. Bagaimana hubungan usia ibu dan riwayat kehamilan ketiga dengan bayi lahir
prematur? (serta faktor risiko riwayat persalinan preterm, jarak antara kehamilan)
(dian, filia)
b. Bagaimana hubungan kontraksi uterus pada kasus? (kelahiran bayi preterm) (azan,
febi)
2. She forgot when her first day of last period, but she thought that her pregnancy was
about 7 months.
a. Bagaimana cara menghitung usia kehamilan? (ballard score) (nining, tika)
3. The baby was not cried spontaneously after birth.
a. Apa penyebab bayi tidak langsung menangis? (nuari, sintia)
4. The baby was grunting and his whole body was cyanosis.

a. Apa penyebab bayi merintih? (nia,malik)

b. Apa penyebab bayi sianosis? (nuari, sintia)
5. Pediatrics residence who resuscitate the baby did first step of resuscitation to the baby.
APGAR score at first minute was 3 and fifth minutes was 7.
a. Bagaimana cara resusitasi pada bayi baru lahir? (tika, ray)
b. Bagaimana cara menghitung dan interpretasi dari APGAR score dari menit pertama
dan menit kelima? (nining, ray)
6. On physical examination:
Body weight was 1350 grams, body length was 41cms, and head circumference was 31
cm. the muscle tone was decreased, he was poorly flexed at the limbs, he has thin skin,
more lanugo over the body and plantar creases 1/3 anterior. At 10 minutes of age, his
still had grunting and cyanosis of the whole body, respiratory rate was 86 breaths per
minute, there were epigastric retraction, breathing sound decreased. Heart rate 156 beats
per minute. Saturation 85% with nasal oxygen.
a. Bagaimana interpretasi dan mekanis abnormal dari Body weight was 1350 grams,
body length was 41cms, and head circumference was 31 cm. the muscle tone was
decreased, he was poorly flexed at the limbs, he has thin skin, more lanugo over the
body and plantar creases 1/3 anterior? (gambar lanugo dan plantar creases) (dian,
filia)
b. Bagaimana interpretasi dan mekanis abnormal dari at 10 minutes of age, his still had
grunting and cyanosis of the whole body, respiratory rate was 86 breaths per minute,
there were epigastric retraction, breathing sound decreased. Heart rate 156 beats per
minute. Saturation 85% with nasal oxygen? (azan, febi)
7. Analisis Aspek Klinis (Respiratory Distress)
a. Bagaimana cara penegakkan diagnosis pada kasus? (tika, ray)
b. Apa diagnosis banding pada kasus? (dian, filia)
c. Diagnosis kerja dan definisi kerja pada kasus? (ray, nining)
d. Apa klasifikasi penyakit pada kasus? (azan, febi)
e. Apa etiologi penyakit pada kasus? (azan, febi)
f. Apa epidimiologi penyakit pada kasus? (nining, tika)
g. Apa faktor risiko penyakit pada kasus? (nuari, sintia)
h. Bagaimana patofisiologi penyakit pada kasus? (nuari, sintia)
i. Apa manifestasi klinis penyakit pada kasus? (nia, malik)
j. Bagaimana tatalaksana dan edukasi (algoritma) penyakit pada kasus? (nia,
malik)
k. Apa komplikasi penyakit pada kasus? (dian, filia)
l. Apa prognosis penyakit pada kasus? (nining, tika)
m. Apa SKDI pada kasus? (ray)

IV.

Hipotesis
Seorang bayi laki-laki lahir preterm, BBLR mengalami respiratory distress.

V. Learning Issues
1. BBLR (Tika, Ray, Nining)
2. Asfiksia Neonatal (Filia, Febi, Dian, Azan)
3. Respiratory Distress. (Nuari, Nia, Sintia, Malik)