Perwira S*, Fazriany N*, Irfansyah*, Husna CA*, Milya V*, Andalas M** Department of obstetric and gynecology Faculty of medicine Syiah Kuala University/ General hospital Zainoel Abidin, Banda Aceh Abstract
A 35-years-old mugltiravida (G3P2Ab0) at 39 weeks of gestation with history of hypertension was admitted in Rumah Sakit umum Zainoel Abidin with eclampsia. Convulsions occurred in the whole body, and convulsions have occurred 3 times before. Length of a convulsion is approximately 3-4 minutes and patient came in apathetic condition. According to the patient’s family, the convulsions had never happened in pregnancies before. On this pregnancy, the patient had complained about feeling dizzy, sore shoulders and since yesterday her vision has blurred. According to family history, High blood pressure have been previously approved since the second pregnancy until now. On admission the blood pressure was 190/140 mmhg, dipstic urine revealed proteinuria (+2), edema anasarka, respiratory distress and deteriorating consciousness. The heart and lung sound were clear and there were no murmurs. On Obstetic examination revealed fetal with normal presentation, fundus uteri length 32 cm and fetal heart rate 185x/minute. The patient had adecuatly his, her cervix was 4 cm dilated and partially effaced on vaginal examination. The laboratory data were as follow Haemoglobin 12,8 gr/dl, haematocrite 43 %, leucocyt 17.800/uL and Trombocyt 150.000/uL. Patient was diagnosed as super imposed eclampsia with aterm gestation. The patient was thus given intravenous magnesium sulphate and perdipine as treatment of eclampsia. The patient then brought to the Intensive Care Unit. She went into spontaneous labour and had Normal vaginal delivery with oxytocin induction. Four hour after admitted she was delivered the baby. The birth weight of the child was 1900g, It was female and the 1 minute apgar score was 5. At this time she had vaginal bleeding of approximately 800 ml on 20 minutes. She had post partum haemorrghae primer e/c atonia uteri. She was administered oxytocin, methergin, misoprostol tab, cristaloid and coloid. Endotracheal intubation was performed but oxygen saturation rapidly fell despite giving 100% oxygen. Cardiopulmonary resuscitation was done but was unsuccessful. The patient died 7 hours after admitted with multi organ failure being the probable cause of death.
Keyword : eclampsia, epigastric pain, blur eye, multi organ failure
*Clinical Internship Students. Department of Obstetric and Gynecology General Hospital Zainal Abidin, Banda Aceh
**Chairman of Obstetric and Gynecology Department, General Hospital Zainal ABidin, Banda Aceh