09

No.

89

03

00

MR

RUMAH SAKIT UMUM FKUKI

SMF OBSTETRI GINEKOLOGI
Jl. Mayjen Sutoyo no. 2, Cawang, Jakarta Timur, 13630
Tel. 021 8092317 ext. 108 / 205

OPERATION REPORT
Name : Mrs. Noraveri
Sex : Female
Operator
Prof. Dr. H. I. O Marsis, SpOG
Anesthetic
Asistern I
dr. Benhur S.
Instrumentator
Asistern II
Hendra Gorbi Tito Manurung
Observer
Pre-operation Diagnose : Pregnancy 38th weeks G2P1A0 + CPD +
previous cesarean delivery at P1A0
Post-operation Diagnose : CPD + prior cesarean delivery + nuchal cord
with one loop
Technique of operation :

1. Sectio caesarean transperitoneal profunda

Age : 33 years
dr. Veronica, Sp. An
Zr. Marintan
Gasha Arya Pratama

Date of operation : November 10th 2014

Duration of operation : 1 hour 15 minutes
Type of operation
Emergency
Policlinic
Elective

Minor
Medium
Mayor

Operation Procedures:
I.

Patient slept in supine position with spinal anesthesia on the operation table.

II.

Applied inside the dower catheter.

III.

Aseptic and antiseptic on abdomen adjacent regio until 1/3 distal upper leg and the operation
field was limited with sterile doek.

IV.

Pfannenstiel incision was made around the fibrous tissue and the skin fold in the lower
abdomen regio, the incision was made deeper slice by slice from cutis, sub cutis, fascia with
sharp technique. Then the musculus rectus abdominis was separated to lateral section with dull
technique, bleeding was taken care off.

V.

The peritoneum parietal was opened upside and downside so we could see the uterine
gravidarum, and two sterile gaas were put inside the right and left abdomen cavity for
separating the uterine and the other organ.

VI.

The plica vesico uterine was opened and the incision was continued to the left and right lateral
and set aside.

VII.

Transversal incision was made on lower segment of uterus, extend to right and left until we
could see the amnion membrane and then the operator broke the amnion membrane, the liquor
amnii was clear and we could saw the babys head.

VIII.

We saw the babys head upper from the pelvic inlet.

IX.

Then the babys head was pulled out by forceps and with mild pressure on the fundus uterine by
assistance. There was a nuchal cord with one loop, then it was released. The delivery was done
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step by step from head, front shoulder, back shoulder, backward anterior trochanter, posterior
trochanter, breech and inferior extremity with a sort umbilical cord coil attached to the baby.
X.

The baby was crying, umbilical cord was clamped on 2 places 5 cm and 7 cm from the
umbilical cord, then it was cut between the 2 clamps and the baby was given to the pediatrician.

XI.

The new born baby was delivered at 8.30 am, with female gender, body weight birth is 3400 gr,
birth length is 48 cm, Apgar Score is 8/9, anal (+) and wasnt seen major congenital disorder.

XII.

Placenta was completely born in manual, cavum uterine was cleaned from the residual placenta
tissue. Bleeding was controlled.

XIII.

After that the uterine tissue was sewed:

-

Suture was done on lower segment of uterine at two pole with Chromic cat gut no. 2 and
then the myometrium tissue was sutured by continue and overhecting.

First slice of myometrium tissue with Chromic cat gut no. 2 by continue.

Second slice of myometrium tissue and serosum was suture by continue with Chromic cat
gut no. 2.

Reperitonisation by sutured plica vesica uterine with chromic cat gut no. 2 by continue.

XIV.

The abdomen cavity was cleaned and two sterile gaas was pulled out from the abdomen cavity.

XV.

Before the abdomen cavity sewed, it was given cortisone acetate 25 mg/10ml into peritoneal
cavity.

XVI.

After ensuring that there was no bleeding, the abdomen cavity was sewed slice by slice.
a. Peritoneum parietal was sutured with Plain cat gut no. 2.0 by continue.
b. M. Rectus abdominis was sutured with Chromic cat gut no. 1.0 by simple suture.
c. Fascia was sutured with vicryl no. 1 by simple suture.
d. Sub cutis was sutured with Plain cat gut no. 2.0 by simple suture.
e. Cutis was sutured with Chromic cat gut no. 3.0 by subkuticuler.

XVII. Bleeding approximately 200 cc.

XVIII. Cavum uterine was cleaned pervaginam.
XIX.

The operation wound was cleaned by cleaning stole cell from the vagina, the operation wound
was cleaned with NaCl 0,9 % and then it was given antibiotic zalf and then was closed by
sufratulle, sterill cassa and tegaderm.

XX.

The operation finished.

The condition of patient post operation:

General condition

: Look mild sick

Blood pressure

: 110/70 mmHg

Pulse rate

: 65 x/minute

Respiration

: 20 x/minute

Temperature

: 37oC

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Tissue to Pathology of Anatomy :

Yes

: Type of tissue ..........................................

No
Operator,

(Prof. dr. H. I. O Marsis, SpOG)

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