Abortus Infeksiosa

A 24-year-old patient came to the Bintang Amin Hospital Emergency Room with a complaint of pelvic pain 2 days ago. Pasiem said a little blood came out of the birth canal and weakness, fever, lower abdominal pain, headache, if BAK hurts. Sometimes os feels the heart pounding. The history of abortion 5 days ago. On the physical examination, vital signs were found, including blood pressure 122/67 mmHg, pulse rate 120 x/minute, respiratory rate 22x/minute, temperature 38.5 °C, oxygen saturation 99%. Head to toe physical examination found that there was pressure pain (+) suprasymphysis on palpation. On examination in the inspection of the presence of blood coming out of the birth canal and no vaginal inspeculo. In the haematological support examination, a decrease in haemoglobin was obtained, 11.4 g/dl, an increase in leucocytes by 12,100 ul, a decrease in MCH of 26 pg, a decrease in MCHC of 32 g/dl. In a complete urine test, an increase in leucocytes was found +++/(500), an increase in urobilinogen +/(2), an increase in faint blood +++/(300), an increase in leucocyte sediment 13-15, an increase in erythrocyte sediment 12-13, a lot of epithelial sediment, a little bacterial sediment. On ultrasound examination obtained D 3.55 cm, D 0.62 cm. The diagnosis in this case is an infectious abortion. The treatment obtained by the patient is IVFD RL 20 tpm, mipros/Misoprostol 2 vaginal tabs 6 hours before curettage, 2x1 curettage, 3x1 treatment, curettage plan. Pasien usia 24 tahun datang ke UGD Rumah Sakit Bintang Amin dengan keluhan nyeri panggul sudah 2 hari yang lalu. Pasiem mengatakan keluar darah sedikit dari jalan lahir dan lemas, demam, nyeri perut bagian bawah, nyeri kepala, jika BAK nyeri terkadang os merasakan jantung berdebar. Riwayat abortus 5 hari yang lalu. Pada pemeriksaan fisik didapatkan tanda-tanda vital diantaranya tekanan darah 122/67 mmHg, denyut nadi 120 x/menit, laju pernapasan 22x/menit, suhu 38,5 °C, saturasi oksigen 99%. Pemeriksaan fisik head to toe didapatkan adanya nyeri tekan (+) suprasimfisis pada palpasi. Pada Pemeriksaan dalam inspeksi adanya keluar darah dari jalan lahir dan tidak dilakukan inspekulo vagina. Pada pemeriksaan penunjang hematologi didapatkan p enurunan hemoglobin 11,4 g/dl, peningkatan leukosit 12.100 ul, penurunan MCH 26 pg, penurunan MCHC 32 g/dl. Pada pemeriksaan urin lengkap didapatkan peningkatan leukosit +++/(500), peningkatan urobilinogen +/(2), peningkatan darah samar +++/(300), peningkatan sedimen leukosit 13-15, peningkatan sedimen eritrosit 12-13, banyak sedimen epitel, sedikit sedimen bakteri. Pada pemeriksaan USG didapatkan D 3.55 cm, D 0.62 cm. Diagnosis pada kasus ini yaitu abortus infeksiosa. Tatalaksana yang didapat oleh pasien yaitu IVFD RL 20 tpm, mipros/Misoprostol 2tab pervaginam 6 jam sebelum kuret, cefat 2x1, lapistan 3x1, rencana kuret.