second day.

second day in second round OBGYN.

I

da dpt semangat blk. td stay lps kelas sampai pukul 630. tk byk case. tp dpt la tgk 1 ceaserian section and 1 normal delivery sampai hbs. seronok. :D

II

jd nomad dan menumpang kump lain dgn dr yg mengajar laju tidak menarik lansung. tp kalau masuk group 8 tkpe.haha.

III

female. coma since after ceasarian section yesterday. caused of coma, still unknown. mayb intracranial hg. dt? unkown. admitted to ICU.

investigation finding: accumulation of blood in the perineum.

a surgery is perform to evacuate the blood and find source of bleeding.

then mayb observation the pt. n btw, the dr use PDS to ligate the a. 

IV

primigravida. full term. epileptic since birth. last attack 5 months ago. took 2 epileptic drugs. err i dont remember the name. surgical hx of tonsillectomy. indication for ceaserian section because afraid attack of epilepsy during labor. CS was perform under general anaesthesia. safely deliver a baby girl. the dr use continuous unlock and horizontal mattress suture on uterus. continuous unlock suture on rectus muscle and rectus sheet. and subcuticular suture on skin. total duration of surgery: 25 minute. woah.

V

how to use pinard stethoscope?

put the pinard on maternal abdomen. put ur ear on the other end of pinard. remove ur hand. try listen to fetal heart sound and identify site of maximum intensity. 

do not touch the pinard while u trying to listen the fetal heard sound.

yeay. i did it!. listening to the real fetal heart sound by pinard for the 1st time!
n i still wonder why pinard is better than stethoscope?

VI

female. full term. P2 G0+1A. during admission, cervix dilatation is only 2 fingers(4cm), 50% effacement, cephalic presentation, membrane rupture. 20min later, dr did PV. cervical dilatation up to 3 fingers(6cm). the next 5min is 3.5 fingers(7cm). the next min is 4 fingers(8cm). and then the next minute is fully dilate. she is primigravida, and she go through the 1st stage of labour less than 30minute! (normal: 12-16 hour) woah! precipitate labour.

2nd stage of labour.

1.evacuate the bladder by urinaty cath

2.do episiotomy after give local anaesthesia

3.mechanism of labor. descend. increase flexion. int rotation. extension. restitution. ext rotation.

4.deliver the baby. support the perineal. baby boy. :))
5.cut the umbilical cord

3rd stage of labour
1.evacuate the bladder
2.massage the uterus while try to extract the umbilical cord.

3.pull out the placenta after appearance signs of placenta separation. (mode of separation: inverted umbrella)

4.after pulling out the placenta, rotate it repeated and slowly to pull out together the remnant. 

5.check if any remnant left inside the uterus.

6.check if any laceration or tear

7.suture the cervix laceration

7.suture back the episiotomy

VII

i finished read face & brow presentation during waiting in the labor room. kira da study la kn hari ni. :))

VIII

3 cases of severe pre eclampsia and 1 case of placenta previa marginalis admitted for observation.

da mengantuk. ke kelas tafaqquh td pun da tersengguk2. esok cuti. yeay! kene bace breech.

buku & nota2 peds tk kemas lg. haha.