laporan skenario d (abortus insipiens)

8/12/2019 Laporan Skenario D (Abortus Insipiens)

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LAPORAN TUTORIAL SKENARIO D BLOK 23 TAHUN 2014

Disusun oleh: Kelom o! 3

Im"m #"hi$ 0411100101%

&l"'" A$eli" (i)"*" 04111001020

Lism*" ("h*u Nin+'um 04111001023

,en-"'i In$"h S"'i 04111001024

Au$'e* (i-"'i 041110010.0

,/ Ri !i 041110010.1

A$i+un" D"'m"n-o 041110010.4

N*im"s In"s ,ell"nis" 041110010.

Rish" ,eilin$" , 041110010.%

#h" h" S" i'" He' '"n"n$" 041110010 1

Li"ni-" 041110010 3

Des* A'*"ni 041110010

R"is" Pu-'i Se5io'i" 041110010%

&"h*o Pu'n"nin+ T*"s 041110010%

Tu-o': $'/ #ul!"'n"in ,us"6 S / PA7K8

PENDIDIKAN DOKTER U,U,

9AKULTAS KEDOKTERAN UNI ERSITAS SRI(I;A


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DA9TAR ISI

H"l"m"n ;u$ul /////////////////////////////////////////////////////////////////////////////////////////////////////////////////////1

K"-" Pen+"n-"' ///////////////////////////////////////////////////////////////////////////////////////////////////////////////////2

D" -"' Isi /////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////3

H"sil Tu-o'i"l $"n Bel")"' ,"n$i'i

I/ Kl"'i i!"si Is-il"h /////////////////////////////////////////////////////////////////////////////////////////////////////////////

II/ I$en-i i!"si ,"s"l"h ///////////////////////////////////////////////////////////////////////////////////////////////////////

III/ An"lisis ,"s"l"h ///////////////////////////////////////////////////////////////////////////////////////////////////////////.

I / Hi o-esis /////////////////////////////////////////////////////////////////////////////////////////////////////////////////////23

/ Ke'"n+!" Konse /////////////////////////////////////////////////////////////////////////////////////////////////////////24

I/ Kesim ul"n /////////////////////////////////////////////////////////////////////////////////////////////////////////////////24

II/ Sin-esis

1/ An"-omi Sis-em Re 'o$u!si ("ni-"////////////////////////////////////////////////////////////////24

2/ A?o'-us ////////////////////////////////////////////////////////////////////////////////////////////////////////////33

3/ Pen*"!i- ,enul"' Se!su"l ///////////////////////////////////////////////////////////////////////////////3%

D" -"' Pus-"!" ///////////////////////////////////////////////////////////////////////////////////////////////////////////////////4

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I. KLARIFIKASI ISTILAH

1/ "+in"l ?lee$in+: !elu"'n*" $"'"h $"'i em?uluh $"'"h $"'i "+in" *"n+ -e'lu!"/

2/ A?$omin"l 5'"m in+: !on-'"!si mus!ul"'Co-o->o-o- "?$omen s "smo$i! *"n+ n*e'i/

3/ B'e"s- -en$e'ness: !e"$""n sensi-i i-"s *"n+ -i$"! ?i"s" -e'h"$" sen-uh"nC-e!"n"n

"$" "*u$"'"/

4/ "+in"l $is5h"'+e: e!s!'esi "-"u su?s-"nsi *"n+ !elu"' $"'i "+in" $ise?u- )u+"

$en+"n $uh/

/ B'e"s- h* e' i+men-e$: i+men-"si *"n+ menin+!"- "?no'm"l "$" "*u$"'"/

./ Sou le: su"'" "us!ul-"si *"n+ ?e'-iu $"n lem?u-/

/ Li i$e: lun-u'6 se e'-i !on-usiC?en$un+"n6 ?e'@"'n" hi-"m "-"u ?i'u/

/ L"se'"si: lu!" *"n+ $ise?"?!"n oleh 'o?e!"n/

%/ Pol* : se-i" e-um?uh"nCm"ss" *"n+ menon)ol $"'i mem?'"n mu!os"/

10/ E'o-ion: -e'!i!isn*" su"-u e'mu!""n/

11/ >H&=: se)enis +li!o 'o-ein *"n+ $ih"sil!"n oleh sel>sel -'o o?l"s-i! $im"n" sel>sel

-e'se?u- h"n*" "$" )i!" -el"h -e')"$i e'-ilis"si/

II. IDENTIFIKASI MASALAH

1/ N*/ T"'i6 3 -"hun6 =3P2A06 $"'i !elu"'+" e!onomi menen+"h $"-"n+ $en+"n

e'$"'"h"n "+in"/ I" )u+" men+eluh !'"m e'u-6 mu"l6 mun-"h6 $"n "*u$"'"

mene+"n+/ An"!n*" *"n+ -e'"!hi' ?e'usi" . -"hun/

2/ I" -i$"! men+"l"mi mens-'u"si sel"m" min++u/

3/ Se)"! 1 -"hun *"n+ l"lu6 i" men+eluh !elu"'n*" se!'e- "+in" *"n+ ?e'?"u -i$"! en"!

$"n !"$"n+>!"$"n+ $ise'-"i +"-"l "$" ul "/

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4/ Su"min*" "$"l"h su i' -'u!/

/ Peme'i!s""n isi!

TB: 1 5m BB: 0 !+ TD: 120C 0 mmH+ Te!"n"n n"$i 0 Cm RR 20 Cm/

Kon)un+-i " "l e?'" no'm"l P"*u$"'" hi e' i+men-"si A?$omen $"-"'6 su le6 sime-'is6

un$us u-e'i -i$"! -e'"?"6 -i$"! "$" m"ss"6 -i$"! "$" n*e'i -e!"n6 $"n -i$"! "$" -"n$" 5"i'"n

?e?"sC"s5i-es/

1/ Peme'i!s""n $"l"m

Peme'i!s""n s e!ulum: o'sio li i$6 os-ium u-e'i e!s-e'n" -e'?u!" $en+"n $"'"h !elu"' $"'i

oue6 -i$"! "$" e'osi6 l"se'"si6 "-"u oli "$" se' i!s/

Peme'i!s""n ?im"nu"l: se' i!s lem?u-6 oue -e'?u!"6 -i$"! "$" 'e+e'"!"n me'e+"n+ se' i!s6

u!u'"n u-e'us se!i-"' usi" +es-"si min++u6 !e$u""$ne!s" $"n "'"me-'ium $"l"m ?"-"s

no'm"l/

2/ L"?o'"-o'ium

H? 11 +C$L Leu!osi- 12/000Cmm 3 LED 1 mmC)"m A us"n $"'"h -e i $"l"m ?"-"s no'm"l

U'in: >H&= F 7 osi-i 8/

III. ANALISIS MASALAH

1. A a e!iolo"i #an $a"ai%ana %ekani&%e er#arahan 'a"ina a#a N(. Tari)

;"@"?:

E!iolo"i e'$"'"h"n T'imes-e' I: A?o'-us Keh"mil"n E!-o i! Te'+"n++u ,ol"

Hi$"-i$os"/ ;i!" -e')"$i e'$"'"h"n "-"u -"m "! ?e'5"! $"'"h sel"m" ?ul"n>?ul"n"@"l !eh"mil"n6 m"!" !emun+!in"n -e')"$in*" "?o'-us h"'us $i5u'i+"i -e'le?ih

$"hulu/A?o'-us: ?e'l"n+sun+ -"n " -in$"!"n 7s on-"n86 e'$"'"h"n se$"n+>?"n*"!6

!'"m "$" e'u-6 u!u'"n u-e'us sesu"i $en+"n usi" +es-"si6 se' i!s -e'?u!"/ D"'i

en)el"s"n -e'se?u-6 m"!" $" "- #i&i% ulkan $ah*a N( Tari %en"ala%i a$or!u& 6

!"'en" i" men+eluh!"n 5'"m in+ $ise'-"i e'$"'"h"n "$" "+in" 7$i"+nosis )u+"

$i "s-i!"n $en+"n mel"!u!"n eme'i!s""n +ine!olo+is8/

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Mekani&%e e'$"'"h"n e' "+in": Te')"$i e'$"'"h"n "$" $esi$u" ?"s"lis $ise'-"i

ne!'osis $"n in l"m"si "$" $"e'"h -e')"$in*" im l"n-"si/ K"n-un+ +es-"si -e'le "s

se5"'" "'si"l "-"u -o-"l/ Te')"$i !on-'"!si u-e'us $"n $il"-"si se' i!s *"n+ !emu$i"n

"!"n men+"!i?"-!"n e!s ulsi $"'i selu'uh 'o$u! !onse si6 *"n+ "@"ln*" $i-"n$"i

oleh -e')"$in*" e'$"'"h"n 7 "+in"l ?lee$in+8/

2. Ba"ai%ana %ekani&%e %ual+ %un!ah+ #an a(u#ara %ene"an")

;"@"?: Mual #an %un!ah mun5ul se+e'" se-el"h im l"n-"si $"n ?e's"m""n s""-

ro#uk&i h,- men5" "i un5"!n*"6 $i$u+" ?"h@" ho'mon l"sen-" inil"h *"n+

memi5u mu"l $"n mun-"h $en+"n ?e!e')" "$" chemoreseptor trigger zone "$"

us"- mun-"h/ A!i?"- $"'i en"aruh hor%on ro"e&!eron #an e&!ro"en sehin++"

en+elu"'"n "s"m l"m?un+ ?e'le?ih"n6 enu'un"n -onus6 $"n mo-ili-"s s"lu'"n

+"s-'oin-es-in"l/

Ma%%ae akan %e%$e&ar #an !e"an" aki$a! hor%one &o%a!o%a%o!ro in+

e&!ro"en #an ro"e&!erone. Es-'o+en menim?ul!"n hi e'-'o i $"l"m s*s-em s"lu'"n6

se$"n+!"n 'o+es-e'one men"m?"h sel>sel "sinus "$" m"m"e/ Som"-om"mo-'o in

mem en+"'uhi e'-um?uh"n sel>sel "sinus $"n menim?ul!"n e'u?"h"n sehin++"

-e')"$i em?u"-"n !"sein6 l"!-"l?umin6 $"n l"!-o+lo?ulin/ Di ?"@"h en+"'uh 'o+es-e'one $"n som"-om"mo-'o inC human placenta lactogen 7hPL8 -e'?en-u! lem"!

$i se!i-"' "l eol">"l eol"6 sehin++" m"m"e men)"$i le?ih ?es"'6 $ise'-"i '"s" enuh

"-"u -e+"n+ $"n sensi-i -e'h"$" sen-uh"n/

3. Ba"ai%ana %ekani&%e kra% eru! #an a a hu$un"ann(a #en"an ka&u& ini)

;"@"?: H"sil !onse si *"n+ le "s se?"+i"n "-"u selu'uhn*" $iin-e' 'e-"si!"n

se?"+"i ?en$" "sin+ u-e'us ?e'!on-'"!si se'in+ $"n !u"- !'"m e'u- 7$i sim isis

?"@"h8/ Hu?un+"n kra% eru! $en+"n !"sus me'u "!"n !an#a warning #an "e ala

klini& !er a#in(a a$or!u& /

4. Ba"ai%ana hu$un"an u&ia+ &!a!u&+ arak keha%ilan+ #an kon#i&i &o&ial ekono%i

!erha#a kon#i&i N(. Tari)

;"@"?: ,enu'u- De !es 7200186 i?u h"mil umu' G 3 -"hun6 !eseh"-"n i?u su$"h

menu'un/ A!i?"-n*"6 i?u h"mil "$" usi" ini mem un*"i !emun+!in"n le?ih ?es"'

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un-u! mem un*"i "n"! 5"5"-6 e's"lin"n l"m"6 $"n en$"'"h"n/ Te')"$i !emun$u'"n

$"n enu'un"n $"*" -"h"n -u?uh -e'h"$" ?e'?"+"i en*"!i-/

S-"-us6 )"'"! !eh"mil"n 7in e'-ili-"s se!un$e' *"n+ $i$u+" $ise?"?!"n oleh i?u

mem"!"i !on-'"se si "!-o' 'isi!o "?o'-us86 $"n !on$isi sosi"l e!onomi 7!u'"n+

mem e'h"-i!"n "su "n nu-'isi $en+"n ?"i!8 -i$"! ?e' en+"'uh se5"'" si+ni i!"n

-e'h"$" !e)"$i"n "?o'-us "$" N*/ T"'i/

/. Ba"ai%ana hu$un"an eker aan &ua%i #en"an keluhan N(. Tari)

;"@"?: !emun+!in"n ?es"' su"mi N*/ T"'i *"n+ menul"'!"n in e!si +eni-"l *"n+ s""-

ini $i"l"mi oleh N*/ T"'i/ Su i' -'u! me'u "!"n !elom o! 'isi!o -in++i -e'!en" P,S

!"'en" mo?ili-"s !e')" me'e!" *"n+ -in++i6 me'e!" me'u "!"n !elom o! s"s"'"n

!e$u" 'io'i-"s $"'i De !es un-u! men5e+"h enul"'"n P,S/

. A a %akna klini& !i#ak %en&!rua&i %in""u)

;"@"?: Ti$"! mens-'u"si sel"m" min++u menun)u!!"n ?"h@" N*/ T"'i h"mil/

=e)"l">+e)"l" *"n+ $i"l"mi 7mu"l6 mun-"h6 "*u$"'" -e+"n+8 $"n enin+!"-"n ho'mon l"sen-" >h&= men+in$i!"si!"n -el"h -e')"$i -e')"$in*" !onse si $"n ni$"si *"n+

men*e?"?!"n -i$"! -e')"$i em?en-u!"n oli!el $e ='"" $"n o ul"si/

. Ba"ai%ana er$e#aan &ekre! 'a"ina i&iolo"i& #an a!olo"i& *arna+ $au+ H+

kon&i&!en&i+ #an e!iolo"i5)

;"@"?:

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Se!'e- "+in" isiolo+is ?e'@"'n" ?enin+6 ?is" u-ih !e'uh "-"u !e!unin+"n se-el"h

!e'in+6 H "s"m 7se!i-"' 36 >46286 !onsis-ensi se e'-i len$i' -e'+"n-un+ si!lus ho'mon6

-i$"! ?e'?"u $"n -i$"! menim?ul!"n !eluh"n/ D" "- -e')"$i s""- men"'!e6 o ul"si6

!ein+in"n se!s menin+!"-6 !eh"mil"n6 ?"*i ?"'u l"hi'6 $"n !e"$""n s-'ess/ 9lo'"

no'm"l "+in" meli u-i Corinebacterium 6 Bacteroides 6 Peptostreptococcus 6

Gardnerella 6 Mobiluncus 6 Mycoplasma $"n Candida s / Lin+!un+"n $en+"n H

"s"m mem?e'i!"n un+si e'lin$un+"n *"n+ $ih"sil!"n oleh Lactobacilli /

Sekre! 'a"ina a!olo"i& $" "- ?e'?"u "mis6 " e!6 ?usu!6 !"$"n+ ?e'5"m u' $"'"h6

?e'@"'n" u-ih susu6 !unin+ -u"6 5o!l"- "-"u !ehi)"u"n/

,iriSekre!

Fi&iolo"i&

6a"ini!i&Non& e&i ik7Bak!eriali&6a"ino&i&

Tri8ho%ona& ,an#i#a -onokoku&

9arna Pu-ih A?u>"?u Kunin+!e"?u>"?u"n

Pu-ih Kunin+!ehi)"u"n

Bau a%i& Ti$"! "$" A$" A$" Ti$"! "$" Ti$"! "$"

Kon&i&!en&i Ti$"!homo+en

Homo+en Pu'ulen6se'in+ $en+"n

+elem?un+

Ke)u$es"

,u!o u'ulen

Le!ak B"+i"n-e'en$"h

,ele!"- "$" $in$in+

Se'in+-e'!um ul $i

o'ni!s

,ele!"- "$"

$in$in+

,ele!"- "$"$in$in+

Sekre! #iin!roi!u&

;"'"n+ L" im L" im L" im L" im

6ul'a No'm"l No'm"l E$em" E'i-em" E'i-em"Muko&a

'a"ina

No'm"l No'm"l Bi"s"n*"

no'm"l

E'i-em" No'm"l

Ser'ik& No'm"l No'm"l ,un+!in Be'5"! Pus $i

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?e'5"!!eme'"h"n

se!'e- o'i isium

. Ba"ai%ana hu$un"an keluar &ekre! 'a"ina $er$au !i#ak enak a#a ka&u& &e ak

1 !ahun (an" lalu #en"an keluhan &ekaran")

;"@"?: Ri@"*"- !elu"' se!'e- "+in" ?e'?"u -i$"! en"! *"n+ $ise'-"i +"-"l se)"!

se-"hun *"n+ l"lu menun)u!!"n -e')"$in*" in e!si "$" N* T"'i/ In e!si ini

!emun+!in"n ?es"' me'u "!"n en*"!i- menul"' se!su"l/

:. A a in!er re!a&i #an %ekani&%e a$nor%al #ari;

Peme'i!s""n isi!

PE,ERIKSAAN HASIL NOR,AL INTERPRETASI ,EKANIS,ETin++i ?"$"n

Be'"- ?"$"n

1// 8%

/0 k"

BBIH J BBIF 7UH 063 8BBIH J 0 F7 063 8 J

0 F26 J/2+ k"BBIJTB>10BBIJ1 >10 5mJ 05m

Kuru& Dari u&ia i$u+

in ek&i+ #an

&o&ial ekono%i

nu!ri&i #an

ro!ein

$erkuran".

Te!"n"n D"'"h 1207 0 %%H" 120C 0

mmH+

Nor%al Peme'i!s""n s e!ulum:

Po'-io li i$e6 $"'"h !elu"' $"'i os-ium u-e'i e -e'n"6 -i$"! "$" e'osi se' i!s6 l"se'"si6 "-"u

oli /

> Peme'i!s""n ?im"nu"l:

Se' i!s lem?u-6 os-ium u-e'i e -e'n" -e'?u!"6 -i$"! "$" mo-ion -en$e'ness "$" se' i!s6

u!u'"n u-e'us !i'">!i'" min++u !eh"mil"n6 "$ne!s" $"n "'"me-'ium $"l"m ?"-"s

no'm"l/

3/ Peme'i!s""n enun)"n+

L"?o'"-o'is : Anemi" 'in+"n/ Peme'i!s""n u'in !"$"' H&= 7F8/

Be'$"s"'!"n h"sil "n"mnesis6 eme'i!s""n isi!6 $"n enun)"n+ *"n+ -el"h $il"!u!"n

$" "- $i-e+"!!"n $i"+nosis A?o'-us Insi iens $en+"n mem e'-im?"n+!"n:

> Ti$"! h"i$ se)"! min++u l"lu6 se'in+ mu"l6mun-"h6 hi e' i+men-"si $"n -en$e'ness

m"m"e6 se' i!s lem?u-6 u!u'"n u-e'us sesu"i !eh"mil"n min++u6 -es u'in >H&= 7F8

N*/ T"'i h"mil/

> Pe'$"'"h"n e' "+in" 7?elum en+elu"'"n h"sil !onse si86 !'"m e'u-6 os-ium u-e'i

-e'?u!" "?o'-us *"n+ se$"n+ men+"n5"m 75i'i A?o'-us insi iens8/

4/ Peme'i!s""n +ine!olo+i

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1/ Ins e!si ul " su$"h $il"!u!"n

Pen$"'"h"n e' "+in"6 "$" "-"u -i$"! h"sil !onse si6 -e'5ium "-"u -i$"! ?"u ?usu! $"'i

ul "/

2/ Ins e!ulum su$"h $il"!u!"n

Os-ium u-e'i -e'?u!" "-"u -e'-u-u 6 "$" "-"u -i$"! 5"i'"n "-"u )"'in+"n ?e'?"u

?usu!C lu!sus $"'i os-ium/

3/ &olo! "+in" su$"h $il"!u!"n

Po'sio m"sih -e'?u!"6 ?es"' u-e'us le?ih !e5il "-"u sesu"i usi" !eh"mil"n6 -i$"! n*e'i s""-

o'sio $i+o*"n+/

/ Peme'i!s""n -"m?"h"n

Peme'i!s""n Do le' "-"u US= un-u! menen-u!"n " "!"h )"nin m"sih hi$u "-"u

su$"h m"-i/

Kul-u' se!'e- "+in" un-u! menen-u!"n en*e?"? in e!si/

Peme'i!s""n )"'in+"n/ ;i!" -e'$" "- sis" )"'in+"n6 $" "- $i!i'im !e l"?o'"-o'ium un-u!

men+!on i'm"si !e+u+u'"n -el"h -e')"$i $"n +e)"l" -i$"! ?e'hu?un+"n $en+"n

en*e?"? l"in $"'i e'$"'"h"n/

11. A a &a a DD a#a ka&u& ini)

;"@"?: A$or!u& : ?e'l"n+sun+ -"n " -in$"!"n 7s on-"n86 e'$"'"h"n se$"n+>?"n*"!6

!'"m "$" e'u-6 u!u'"n u-e'us sesu"i $en+"n usi" +es-"si6 se' i!s -e'?u!"/

Keh"mil"n e!-o i! -e'+"n++u: Kol" s $"n !elel"h"n6 n"$i 5e "- $"n lem"h

7110 Cmeni- "-"u le?ih86 hi o-ensi6 hi o olemi"6 "?$omen "!u- $"n n*e'i el is6

$is-ensi "?$omen $en+"n shi -in+ $ullness me'u "!"n e-un)u! "$"n*" $"'"h ?e?"s6

n*e'i le "s6 u5"-/ P"$" eme'i!s""n isi! $i-emu!"n: "$" -"n$" "!u- "?$omen6 "$"

n*e'i +o*"n+ o'sio/

Keh"mil"n mol" hi$"-i$os": mu"l $"n mun-"h *"n+ he?"-6 u-e'us le?ih ?es"' $"'i usi"

!eh"mil"n6 enin++i"n >h&=6 "$"n*" +elem?un+ mol"6 $"n "$" eme'i!s""n US=

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-e'$" "- +"m?"'"n ?"$"i s"l)u 7 snow flake pattern 8 "-"u +"m?"'"n se e'-i s"'"n+ le?"h

7honey comb 8/

-e ala #an

!an#a

A$or!u&

in&i ien&

A$or!u&

i%%inen&

Mola

hi#a!i#o&a

KET

"+in"

?lee$in+

F F F F

Ri@"*"-

in e!si

F FC> FC> >

Pem?es"'"n

u-e'us

Sesu"i umu'!eh"mil"n


Ti$"! sesu"iumu' !eh"mil"n

7G ?es"'8


Po'-io li i$e F F F F

OUE -e'?u!" F > > >L"se'"si

5e' i

> > > >

Be-" H&= F F F FDem"m > > > >Leu!osi-osis FC> FC> > >

"+in"l

$is5h"'+e

> > > >

N*e'i -e!"n

"$" u-e'us

FC> > F >

P"'"me-'ium

$"n "$ne!s"

No'm"l No'm"l No'm"l A$" )"nin

12. A a #ia"no&i& ker a a#a ka&u& ini)

;"@"?: N*/ T"'i6 3 -"hun6 =3P2A06 men+"l"mi "?o'-us insi ien e/5 sus e! in e!si

menul"' se!su"l/

13. A a e!iolo"i #ari #ia"no&i& ker a a#a ka&u& ini)

;"@"?: Se e'-i *"n+ !i-" !e-"hui6 en*e?"? "?o'-us ?e' "'i"si $"n se'in+ $i e'$e?"-!"n/

Umum*" le?ih $"'i s"-u en*e?"?/ Pen*e?"? -e'?"n*"! $i "n-"'"n*" "$"l"h:

9"!-o' +ene-i!

Kel"in"n !on+eni-"l u-e'us

Au-oimun

De e! "se lu-e"l

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16/50

In e!si

Hem"-olo+i

Lin+!un+"n

P"$" !"sus N* T"'i6 !emun+!in"n en*e?"? "?o'-us "$"l"h in e!si se!su"l menul"'$"n 'esi!o -in++i usi" !eh"mil"n 3 -"hun/

In ek&i. Teo'i e'"n mi!'o?" in e!si -e'h"$" !e)"$i"n "?o'-us mul"i $i$u+" se)"! -"hun

1%1 / Be?e'" " )enis o'+"nisme *"n+ $i$u+" ?e'$"m "! "$" !e)"$i"n "?o'-us "n-"'"

l"in:

B"!-e'i

- Lis-e'i" monosi-o+enes

- Kl"mi$i" -'"!om"-is- U'e" l"sm" u'e"li-i!um

- ,i!o l"sm" hominis

- B"!-e'i"l "+inosis

i'us

- Si-ome+"lo i'us

- Ru?el"

- He' es Sim le!s i'us 7HS 8- Hum"n Immuno$e i5ien5* i'us 7HI 8

- P"' o i'us

P"'"si-

- To o l"smosis +on$ii

- Pl"smo$ium "l5i "'um

S i'o!"e-"

- T'e onem" "lli$umSe$"n+!"n un-u! men+e-"hui e-iolo+i $"'i in e!si s"lu'"n +eni-"l "$" N* T"'i6 e'lu

$il"!u!"n eme'i!s""n mi!'o?iolo+i le?ih l"n)u-/

14. A a e i#e%iolo"i a#a ka&u& ini)

;"@"?: R"-">'"-" -e')"$i 114 !"sus "?o'-us e' )"m/ Se?"+i"n ?es"' s-u$i men*"-"!"n

!e)"$i"n "?o'-us s on-"n "n-"'" 1 >20 M $"'i semu" !eh"mil"n/ Kel"u $i!")i le?ih )"uh6

"?o'-us se?en"'n*" ?is" men$e!"-i 0M/ H"l ini $i!"'en"!"n -in++in*" "n+!" 5hemi5"l

16


17/50

'e+n"n5* loss *"n+ -i$"! ?is" $i!e-"hui "$" 2>4 min++u se-el"h !onse si

7P'"@i'oh"'$)o6 200 8/

(HO mem e'!i'"!"n $i selu'uh $uni"6 $"'i 4. )u-" !el"hi'"n e'-"hun -e'$" "- 20

)u-" !e)"$i"n "?o'-us/ Se!i-"' 13 M $"'i )uml"h -o-"l !em"-i"n i?u $i selu'uh $uni"

$i"!i?"-!"n oleh !om li!"si "?o'-us/

Di In$onesi" se-i" -"hun sel"lu $il"!u!"n en5"-"-"n $is-'i?usi en*"!i- oleh

De "'-emen Keseh"-"n RI *"n+ s"l"h s"-un*" "$"l"h en*"!i- !eh"mil"n/ Di!e-"hui

)uml"h "sien "?o'-us *"n+ men)"l"ni '"@"- in" "$" -"hun 200. se?"n*"! 42/3 4

o'"n+6 $en+"n )uml"h "sien menin++"l $uni" se?"n*"! 20 o'"n+/

D"'i $"-" *"n+ $i e'oleh $"'i 'e!"m me$i! $i Rum"h S"!i- Umum Pus"- D'

,oh"mm"$ Hoesin P"lem?"n+ -"hun 200.6 "n+!" !e)"$i"n "?o'-us se?es"' 123 !"sus

$en+"n !e)"$i"n "?o'-us imminens se?"n*"! 10. !"sus 7 .61 M86 "?o'-us !om li-

se?"n*"! 2 !"sus 716.2 M86 "?o'-us in!om lise?"n*"! 12 !"sus 7%6 M8 $"n misse$

"?o'-ion se?"n*"! 3 !"sus 72644M8/

1/. A a ak!or ri&iko a#a ka&u& ini)

;"@"?: 1/ usi" 20 -"hun "l"- 'e 'o$u!si ?elum m"-"n+ $"n ?elum si" un-u! h"mil

$"n G3 -"hun "n+!" !e)"$i"n !el"in"n !'omosomC-'isomi "!"n menin+!"-/

2/ "'i-"s 1 $"n G3 menin+!"-!"n 'isi!o -e')"$in*" !om li!"si !eh"mil"n6 e's"lin"n6

$"n ni "s/

17


18/50

3/ 'i@"*"- "?o'-us se?elumn*" 71 !"li 1 M "?o'-us l"+i 2 !"li 2 M G3 !"li 30>

4 M8 menim?ul!"n en*uli- !eh"mil"n m"u un "$" h"il !eh"mil"n i-u sen$i'i/ Pen*uli-

e's"lin"n 'em"-u'6 "?o'-us ?e'ul"n+6 $"n ?"*i $en+"n BBLR/

4/ eme'i!s""n "n-en"-"l -i$"! ?"i! menin+!"-!"n 'isi!o !eh"mil"n 7'isi!o

!es"!i-"n $"n !em"-i"n8 !"'en" suli- un-u! men$e-e!si !el"in"n $"n !e?u-uh"n *"n+

$i e'lu!"n i?u $"l"m mem e'si" !"n !eh"mil"n $"n e's"lin"n se5"'" o -im"l/

/ en$i$i!"n 1>% -"hun menin+!"-!"n !emun+!in"n "?o'-us/ I?u $en+"n

en$i$i!"n -in++i le?ih mem e'h"-i!"n !eseh"-"n $i'i $"n !elu"'+"n*"/

./ me'o!o! 'isi!o "?o'-us/

/ "l!ohol "?o'-us s on-"n $"n "nom"li )"nin/

1 . Ba"ai%ana a!o i&iolo"i a#a ka&u& ini)

;"@"?: P"-o isiolo+i -e')"$in*" !e+u+u'"n mul"i $"'i -e'le "sn*" se?"+i"n hin++"

selu'uh )"'in+"n l"sen-"6 *"n+ !emu$i"n "!"n men*e?"?!"n e'$"'"h"n sehin++" )"nin

!e!u'"n+"n nu-'isi $"n o!si+en/ Pen+elu"'"n -e'se?u- $" "- -e')"$i s on-"n selu'uhn*"

"-"u se?"+i"n m"sih -e'-in++"l6 *"n+ men*e?"?!"n ?e'?"+"i en*uli-/ Oleh !"'en" i-u6

"?o'-us "!"n mem?e'i!"n +e)"l" umum !'"m "?$omen !"'en" "$"n*" !on-'"!si '"him6

e'$"'"h"n6 $"n $ise'-"i en+elu"'"n selu'uh "-"u se?"+i"n h"sil !onse si/

Ben-u! e'$"'"h"n ?e' "'i"si:

Se$i!i->se$i!i- $"n ?e'l"n+sun+ l"m"

Se!"li+us $"l"m )uml"h ?es"' $" "- $ise'-"i +um "l"n/

A!i?"- e'$"'"h"n $" "- menim?ul!"n s*o!6 -"!i!"'$i6 hi o-ensi6 "nemi"6 $"n

u)un+ 7"!'"l8 $in+in/

P"$" "@"l "?o'-us -e')"$i e'$"'"h"n $esi$u" ?"s"lis6 $ii!u-i ne!'osis )"'in+"n

se!i-"' *"n+ men*e?"?!"n h"sil !onse si -e'le "s $"n $i"n++" ?en$" "sin+ $"l"m

u-e'us/ Kemu$i"n u-e'us ?e'!on-'"!si un-u! men+elu"'!"n ?en$" "sin+ -e'se?u-/

P"$" !eh"mil"n !u'"n+ $"'i . min++u6 illi !o-"'is ?elum menem?us $esi$u" se5"'"

$"l"m6 )"$i h"sil !onse si $" "- $i!elu"'!"n selu'uhn*"/ P"$" !eh"mil"n s"m "i 14

min++u6 enem?us"n su$"h le?ih $"l"m hin++" l"sen-" -i$"! $ile "s!"n sem u'n" $"n

menim?ul!"n ?"n*"! e'$"'"h"n/ P"$" !eh"mil"n le?ih $"'i 14 min++u6 )"nin

$i!elu"'!"n le?ih $"hulu $"'i "$" l"sen-"/ H"sil !onse si !elu"' $"l"m ?e'?"+"i

18


19/50

?en-u!6 se e'-i !"n-on+ !oson+ "mnion "-"u ?en$" !e5il *"n+ -"! )el"s ?en-u!n*"

7li+h-e$ o um8 )"nin l"hi' m"-i6 )"nin m"sih hi$u 6 mol" !'uen-"6 e-us !om 'esus6

m"se'"si "-"u e-us " i'"seus/

1 . Ba"ai%ana a!o"ene&i& a#a ka&u& ini)

;"@"?: ,enu'u- S"s-'"@in"-" $"n !"@"n>!"@"n 7200 86 !e?"n*"!"n "?o'-us

s on-"n -e')"$i se+e'" se-el"h !em"-i"n )"nin *"n+ !emu$i"n $ii!u-i $en+"n

e'$"'"h"n !e $"l"m $esi$u" ?"s"lis6 l"lu -e')"$i e'u?"h"n> e'u?"h"n ne!'o-i! "$"

$"e'"h im l"n-"si6 in il-'"si sel>sel e'"$"n+"n "!u-6 $"n "!hi'n*" e'$"'"h"n e'

"+in"m/ Bu"h !eh"mil"n -e'le "s selu'uhn*" "-"u se?"+i"n *"n+ $iin-e' 'e-"si!"n

se?"+"i ?en$" "sin+ $"l"m 'on++" '"him/ H"l ini men*e?"?!"n !on-'"!si u-e'us

$imul"i6 $"n se+e'" se-el"h i-u -e')"$i en$o'on+"n ?en$" "sin+ i-u !elu"' 'on++"'"him 7e!s ulsi8/ Pe'lu $i-e!"n!"n ?"h@" "$" "?o'-us s on-"n6 !em"-i"n em?'io

?i"s"n*" -e')"$i "lin+ l"m" $u" min++u se?elum e'$"'"h"n/ Oleh !"'en" i-u6

en+o?"-"n un-u! mem e'-"h"n!"n )"nin -i$"! l"*"! $il"!u!"n )i!" -el"h -e')"$i

e'$"'"h"n ?"n*"! !"'en" "?o'-us -i$"! $" "- $ihin$"'i/ Se?elum min++u !e>106 h"sil

!onse si ?i"s"n*" $i!elu"'!"n $en+"n len+!" / H"l ini $ise?"?!"n se?elum min++u

!e>10 ili !o'i"lis ?elum men"n"m!"n $i'i $en+"n e'"- !e $"l"m $esi$u" hin++" -elu'

mu$"h -e'le "s !eselu'uh"nn*"/ An-"'" min++u !e>10 hin++" min++u !e>12 !o'ion-um?uh $en+"n 5e "- $"n hu?un+"n ili !o'i"lis $en+"n $esi$u" m"!in e'"- hin++"

mul"i s""- -e'se?u- se'in+ sis">sis" !o'ion 7 l"sen-"8 -e'-in++"l !"l"u -e')"$i "?o'-us/

Pen+elu"'"n h"sil !onse si $i$"s"'!"n 4 5"'":

i/ Kelu"'n*" !"n-on+ !o'ion "$" !eh"mil"n *"n+ s"n+"- $ini6 menin++"l!"n sis"

$esi$u"/ ii/ K"n-on+ "mnion $"n isin*" 7 e-us8 $i$o'on+ !elu"'6 menin++"l!"n !o'ion

$"n $esi$u"/

iii/ Pe5"hn*" "mnion -e')"$i $en+"n u-usn*" -"li us"- $"n en$o'on+"n )"nin !e

lu"'6 -e-" i mem e'-"h"n!"n sis" "mnion $"n !o'ion 7h"n*" )"nin *"n+ $i!elu"'!"n8/

19


20/50

i / Selu'uh )"nin $"n $esi$u" *"n+ mele!"- $i$o'on+ !elu"' se5"'" u-uh/ Ku'e-"si

$i e'lu!"n un-u! mem?e'sih!"n u-e'us $"n men5e+"h e'$"'"h"n "-"u in e!si le?ih

l"n)u-/

1 . A a &a a %ani e&!a&i klini& #ari ka&u& ini)

;"@"?: "/ Pen$"'"h"n e' "+in" ?e'"-6 !elu"' +um "l"n $"'"h6 ?e'-"m?"h sesu"i $en+"n

em?u!""n se' i!s u-e'us $"n umu' !eh"mil"n6 ?u-uh !u'"n+ $"'i meni- un-u! ?"s"hi

em?"lu- "$" !eh"mil"n !u'"n+ $"'i 20 min++u6

?/ R"s" mules "-"u !'"m e'u-6 n*e'i !"'en" !on-'"!si '"him *"n+ se'in+ $"n !u"-6

5/ Pem?u!""n os-eum u-e'i6 se' i!s men$"-"' $"n -e'"?" !e-u?"n6

$/ H"sil !onse si m"sih $"l"m !" um u-e'i6 m"sih $"l"m 'oses en+elu"'"n6

e/ Bes"' u-e'us m"sih sesu"i $en+"n umu' !eh"mil"n6

/ Tes u'in !eh"mil"n m"sih osi-i /

1:. Ba"ai%ana !a!alak&ana #ari ka&u& ini)

;"@"?:

20


21/50

P"$" en"n+"n"n -"h" e'-"m" $il"!u!"n ?e'?"+"i !e+i"-"n6 ?e'u " :

"/ ,em"n-"u -"n$">-"n$" i-"l 7men+u!u' -e!"n"n $"'"h6 'e!uensi $en*u- n"$i6 'e!uensi

e'n" "s"n6 $"n suhu ?"$"n8/

?/ Pen+"@"s"n e'n" "s"n 7;i!" "$" -"n$">-"n$" +"n++u"n e'n" "s"n se e'-i "$"n*"

-"!i nu6 si"nosis6 s"lu'"n n" "s h"'us ?e?"s $"'i h"m?"-"n/ D"n $i?e'i o!si+en mel"lui

!"-e-e' n"s"l8/

5/ Sel"m" ?e?e'" " meni- e'-"m"6 en$e'i-" $i?"'in+!"n $en+"n osisi T'en$elen?u'+/

$/ Pem?e'i"n in us 5"i'"n 7$"'"h8 in-'" en" 75"m u'"n De!s-'ose M $en+"n N"&l 06%M6

Rin+e' l"!-"-8/

e/ Pen+"@"s"n )"n-un+ 79un+si )"n-un+ $" "- $i "n-"u $en+"n ele!-'o!"'$io+'" i $"n

$en+"n en+u!u'"n -e!"n"n en" sen-'"l8/

/ Peme'i!s""n l"?o'"-o'ium/ Peme'i!s""n $"'"h len+!" 6 +olon+"n $"'"h6 )enis Rhesus6

Tes !esesu"i"n $"'"h en$e'i-" $en+"n $"'"h $ono'6 eme'i!s""n H $"'"h6 O26 &O2

$"'"h "'-e'i"l/ ;i!" $"'i eme'i!s""n ini $i)um "i -"n$">-"n$" "nemi" se$"n+ s"m "i ?e'"-6

in us 5"i'"n $i+"n-i $en+"n -'"ns usi $"'"h "-"u in us 5"i'"n ?e's"m""n $en+"n -'"ns usi

$"'"h/ D"'"h *"n+ $i?e'i!"n $" "- ?e'u " e'i-'osi-6 )i!" su$"h -im?ul +"n++u"n

em?e!u"n $"'"h6 se?"i!n*" $i?e'i $"'"h se+"'/ ;i!" su$"h -im?ul -"n$">-"n$" "si$osis

h"'us se+e'" $i!o'e!si/

Tatalaksana abortus insipiens: !" kuretase" uterotonika" dan antibiotik :

Bil" e'$"'"h"n -i$"! ?"n*"!6 -un++u -e')"$in*" "?o'-us s on-"n -"n " e'-olon+"n

sel"m" 3. )"m $en+"n $i?e'i!"n mo' in/

Bil" "$" -"n$">-"n$" s*o! m"!" $i"-"si $ulu $en+"n em?e'i"n 5"i'"n $"n -'"ns use

$"'"h/ Kemu$i"n6 )"'in+"n $i!elu"'!"n se5e "- mun+!in $en+"n me-o$e $i+i-"l $"n!u'e-"se/ Se-el"h i-u6 ?e'i o?"->o?"- u-e'o-oni!" $"n "n-i?io-i!"/

L"!u!"n 'ose$u' e "!u"si h"sil !onse si

- Bil" usi" +es-"si 1. min++u e "!u"si $il"!u!"n $en+"n e'"l"-"n As i'"si "!um

,"nu"l 7A ,8 se-el"h ?"+i"n )"nin $i!elu"'!"n/

- Bil" usi" +es-"si G 1. min++u e "!u"si $il"!u!"n $en+"n 'ose$u' Dil"-"si $"n

Ku'e-"se 7D K8

Bil" 'ose$u' e "!u"si -i$"! $" "- se+e'" $il"!s"n"!"n "-"u usi" +es-"si le?ih ?es"' $"'i1. min++u6 l"!u!"n -in$"!"n en$"hulu"n $en+"n:

21


22/50

- In us o!si-osin 20 uni- $"l"m 00 ml NS "-"u RL mul"i $en+"n -e-esCmeni- *"n+

$" "- $in"i!!"n hin++" 40 -e-esCmeni-6 sesu"i $en+"n !on$isi !on-'"!si u-e'us hin++"

-e')"$i en+elu"'"n h"sil !onse si/

- E'+ome-'in 062 m+ I, *"n+ $iul"n+i 1 meni- !emu$i"n/

- ,iso 'os-ol 400 m5+ e' o'"l $"n " "?il" m"sih $i e'lu!"n $" "- $iul"n+i $en+"n

$osis *"n+ s"m" se-el"h 4 )"m $"'i $osis "@"l/

H"sil !onse si *"n+ -e'sis" $"l"m !" um u-e'i $" "- $i!elu"'!"n $en+"n A , "-"u

D K

P"s5" !u'e-"se: ?e'i u-e'o-oni!" $"n "n-i?io-i5 7Do *5*5line6 100 m+Co'"l6 2 1

sel"m" h"'i Amo *sillin 3 00 m+C h"'i > h"'i ,e-*l E'+ome-'in 3 1 -"?C

h"'i h"'i 8

Asuh"n "s5"!e+u+u'"n:

1/ Tin$"!"n en+o?"-"n "?o'-us insi iens $en+"n se+"l" !emun+!in"n !om li!"sin*"/

2/ Konselin+ $"n el"*"n"n !on-'"se si "s5"!e+u+u'"n/

22


23/50

Kesu?u'"n se+e'" !em?"li se-el"h 12 h"'i "s5""?o'-us/ Un-u! Se5"'" '"!-e! h"m i'

semu" )enis !on-'"se si $" "- $i "!"i "s5""?o'-us/

3/ Pel"*"n"n Keseh"-"n Re 'o$u!si Te' "$u

20. A a ko% lika&i ka&u& ini)

;"@"?:

Anemi" "!i?"- e'$"'"h"n

Pe'$"'"h"n6 5"'" men+"-"sin*" $en+"n men+oson+!"n u-e'us $"'i sis"Qsis" )"nin $"n

-'"ns use $"'"h6 ?il" -i$"! se+e'" $i-olon+ men*e?"?!"n !em"-i"n/

Pe' o'"si !"'en" -in$"!"n !u'e-

Pe' o'"si u-e'us "$" !e'o!"n $" "- -e')"$i -e'u-"m" "$" u-e'us $"l"m osisi

hi e''e-'o le!si/ A "?il" -e')"$i e' o'"si6 l" "'o-omi h"'us se+e'" $il"!u!"n un-u!

menen-u!"n lu"s 5e$e'" sehin++" $" "- $il"!u!"n -in$"!"n sel"n)u-n*"/

In e!si

S*o! en$"'"h"n "-"u s*o! en$ose -i!

S*o! -e')"$i !"'en" e'$"'"h"n $"n in e!si ?e'"-/

21. Ba"ai%ana ro"no&i& ka&u& ini)

;"@"?:

23


24/50

I?u i-"m: Du?i" "$ ?on"m 9un+sion"l: Du?i"

;"nin i-"m $"n un+sion"l : $u?i" "$ m"l"m/

22. Ba"ai%ana en8e"ahan ka&u& ini)

;"@"?:

1/ L"!u!"n eme'i!s""n )"nin se5"'" ?e'!"l" 7AN&8 1 !"li "$" -'imes-e' e'-"m"6 1 !"li

"$" -'imes-e' !e$u"6 $"n 2 !"li "$" -'imes-e' !e-i+" $i $o!-e' !"n$un+"n/

2/ ,emo$i i!"si +"*" hi$u

> ,"!"n m"!"n"n *"n+ seh"- $"n ?e'+i i

> ,en5u!u i !e?u-uh"n i-"min $"n mine'"l

3/ Hin$"'i "!-o' 'esi!o

> Hin$"'i ?e'+"n-i>+"n-i "s"n+"n un-u! men+hin$"'i en*"!i- menul"' se!su"l

> ,en)"+" s"ni-"si +eni-"li" in$i i$u

> Su"mi $i e'i!s" $"n $i?e'i!"n en+o?"-"n )i!" in$i!"si P,S6 !oi-us $en+"n "l"-

en+"m"nC!on-'"se si/

23. A a SKDI a#a ka&u& ini)

;"@"?:

24


25/50

I6. HIC TESIS

N*/ T"'i6 3 -"hun6 =3P2A06 men+"l"mi "?o'-us insi ien e- 5"us" sus e! in e!si Pen*"!i-

,enul"' Se!su"l 7P,S8/

6. KERAN-KA K NSEC

25

Ny. Tari hamil

Infeksi PMSm!r 37 "ah!n

Per#arahan#esi#!a

$isik%a&n%rmali"as

kr%m%s%m Nekr%sis 'arin(an

)ram *er!"

)%nse*si"erle*as

+&%r"!s

,is har(e a(ina

/a"al *a#a !l a

Per#arahan*er a(ina


26/50

6I. KESIMC LAN

N*/ T"'i6 3 -"hun6 P2A16 men+"l"mi "?o'-us insi ien e- 5"us" sus e! in e!si Pen*"!i-

,enul"' Se!su"l 7P,S8/

6II. LEARNIN- ISS ES

1. Ana!o%i Si&!e% Re ro#uk&i 9ani!a

O'+"n 'e 'o$u!si e'em u"n -e'?"+i "-"s :1/ O'+"n +eni-"li" e!s-e'n" 7?"+i"n un-u! s"n++"m"82/ O'+"n +eni-"li" in-e'n" 7?"+i"n un-u! o ul"si6 -em "- em?u"h"n sel -elu'6 -'"ns o'-"si

?l"s-o!is-6 im l"n-"si $"n -um?uh !em?"n+ )"nin8/

1.1. r"an "eni!alia ek&!ernaO'+"n +eni-"li" e!s-e'n" ?i"s" $ise?u- ul "6 meli u-i se?u" o'+"n *"n+ -"m "! $"'i lu"' $"n

-e'$" "- $i "n-"'" os u?is $"n e'ineum/ ul " -e'$i'i "-"s:

1. Mon& 'eneri& a!au %on& u$i&,ons u?is "$"l"h )"'in+"n lem"! *"n+ menon)ol "$" ?"+i"n $e "n sim isis u?is *"n+se-el"h u?e'-"s "!"n $i-u-u oleh '"m?u- !em"lu"n *"n+ umumn*" ?e'?en-u! se+i-i+"$en+"n $"s"' "$" -e i "-"s sim isis $"n melu"s !e ?"@"h s"m "i sisi lu"' l"?i" m"*o'"/

2. La$ia %a(ora,e'u "!"n )"'in+"n lem"! *"n+ menon)ol $"'i mons u?is !e ?"@"h ?el"!"n+6 $im"n"

?"+i"n !"n"n $"n !i'i l"?i" m"*o'" ?e'-emu mem?en-u! !omissu'" os-e'io'/

26


27/50

3. La$ia %inora,e'u "!"n li "-"n i ih *"n+ -e'le-"! $i se?el"h me$i"l l"?i" m"*o'"/ Ke $e "n !e$u" l"?i"mino'" ?e'-emu $i "-"s !li-o'is mem?en-u! 'e u-ium !li-o'i$is $"n *"n+ $i ?"@"h !li-o'ismem?en-u! 'enulum/ Ke ?el"!"n+ !e$u" l"?i" ini )u+" ?e's"-u $"n mem?en-u! oss"

n" i5ul"'e6 *"n+ -"m "! u-uh "$" e'em u"n *"n+ ?elum mel"hi'!"n $"n -"m "! -e?"l $"n-i$"! '"-" "$" e'em u"n *"n+ e'n"h mel"hi'!"n6L"?i" mino'" $i-u-u e i-el +e en+ ?e'l" is $en+"n -on)ol"n>-on)ol"n " il6 $"n men+"n$un+

?"n*"! +l"n$ul" se?"se" se'-" u)un+>u)un+ s"'" *"n+ men*e?"?!"n l"?i" mino'" s"n+"-sensi-i

4. Kli!ori&Te'-u-u oleh 'e u-ium !li-o'i$is *"n+ -e'$i'i "-"s +l"ns !li-o'i$is6 !o' us !li-o'i$is $"n $u"!'u'" *"n+ men++"n-un+!"n !li-o'is !e os u?is/ =l"ns !li-o'is -e'$i'i "-"s )"'in+"n *"n+$" "- men+em?"n+6 enuh $en+"n u'"- s"'" sehin++" s"n+"- sensi-i

/. Sela u! #ara hymen 5H*men -e'u-"m" -e'$i'i "-"s )"'in+"n en+i!"- el"s-i5 $"n !ol"+en *"n+ $i-u-u se?el"h $"l"m$"n lu"' oleh e i-el +e en+ ?e'l" is6 -i$"! "$" !elen)"' "-"u elemen>elemen o-o- $"n -i$"!

?"n*"! men+"n$un+ se'"?u->se'"?u- s"'" / Bi"s"n*" h*men ?e'lu?"n+ !e5il s"m "i se?es"'u)un+ )"'i "-"u 2 )"'i/

. 6e&!i$ulu%es-i?ulum me'u "!"n su"-u $"e'"h $i "n-"'" !e$u" l"?i" mino'" !"n"n !i'i $"n melu"s $"'i

!li-o'is s"m "i 'enulum l"?io'um u$en$"/ Ku'"n+ le?ih 1>16 5m $i ?"@"h !li-o'is$i-emu!"n o'i isium u'e-'" e!s-e'num/

. Kelen ar Bar!holinDi !i'i $"n !"n"n $e!"- oss" n" i!ul"'e -e'$" "- !elen)"' B"'-holin/ Kelen)"' ini ?e'u!u'"n$i"me-e' le?ih !u'"n+ 1 5m6 -e'le-"! $i ?"@"h o-o- !ons-'i!-o' !unni/ P"$" @"!-u '"n+s"n+"nse!su"l6 !elen)"' ini men+elu"'!"n len$i'/

. Bul$u& 'e&!i$ule,e'u "!"n !um ul"n en" *"n+ -e'le-"! $i ?"@"h sel" u- len$e' es-i?ulum6 $e!"- '"mus os

u?is/ Bulu?us es-i?ule se?"+i"n -e'-u-u oleh mus!ulus is!io !" e'nosus $"n mus!ulus!ons-'i!-o' "+in"/ Se5"'" em?'iolo+i!6 ?ul?us es-i?ule homolo+ $en+"n !o' us !" e'nosus/P"$" @"!-u e's"lin"n ?i"s"n*" !e$u" ?ul?us -e'-"'i! !e "-"s s"m "i $i ?"@"h "'!us u?is6!"$"n+>!"$"n+ ?ul?i es-i?ule $" "- lu!" $"n 'o?e! sehin++" menim?ul!"n en$"'"h"n

?"n*"! $"n hem"-om" ul "e/

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1.2. r"an "eni!alia in!erna

1. 6a"ina

"+in" me'u "!"n s"lu'"n mus!ulomem?'"nos" *"n+ men+hu?un+!"n ul " $"n u-e'us $"n-e'le-"! $i "n-"'" esi!" u'in"'i" $"n 'e5-um/ Di un5"! "+in" $i is"h!"n oleh se' i!s6-e'?en-u! o'ni!s "n-e'io'6 os-e'io' $"n l"-e'"lis !i'i $"n !"n"n/ 9o'ni!s mem un*"i "'-i!lini! !"'en" o'+"n in-e'n"l el is $" "- $i "l "si mel"lui $in$in+ o'ni!s *"n+ -i is/ Sel"ini-u6 o'ni!s os-e'io' $" "- $i+un"!"n se?"+"i "!ses m"su! !e $"l"m 'on++" e'i-oneum/Ben-u! $"l"m "+in" ?e'li "->li "- $ise?u- 'u++"e/ Di "+in" -i$"! $i$" "-!"n !elen)"'>!elen)"' ?e'se!'esi/ E i-el "+in" -e'$i'i "-"s e i-el +e en+ -i$"! ?e'-"n$u!6 $i ?"@"hn*"-e'$" "- )"'in+"n i!"- *"n+ men+"n$un+ ?"n*"! em?uluh $"'"h6a&kulari&a&i 'a"ina;1/ A'-e'i" u-e'ine6 mem?e'i!"n "s!ul"'is"si !e "$" 1C3 "+in" ?"+i"n "-"s2/ A'-e'i" esi!"lis in e'io'6 mem?e'i!"n "s!ul"'is"si !e "$" 1C3 "+in" ?"+i"n -en+"h

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3/ A'-e'i" hemo'oi$"lis me$i"n" $"n "'-e'i" i$en$us in-e'n" *"n+ mem?e'i!"n $"'"h !e"+in" 1C3 ?"+i"n ?"@"h/

D"'"h !em?"li mel"lui le!sus enosus *"n+ men+i!u-i "'-e'i" $"n m"su! !e $"l"m en"hi o+"s-'i!"/

Li% a!i&a&i 'a"ina;=e-"h ?enin+ *"n+ ?e'"s"l $"'i 2C3 ?"+i"n "-"s "+in" "!"n mel"lui !elen)"' +e-"h ?enin+ $i$"e'"h "s" ili"!"6 se$"n+!"n +e-"h ?enin+ *"n+ ?e'"s"l $"'i 1C3 ?"+i"n ?"@"h "!"n mel"lui!elen)"' +e-"h ?enin+ $i 'e+ion in+uin"lis/

2. !eru&U-e'us ?e'?en-u! se e'-i ?u"h " o!"$ *"n+ se$i!i- +e en+ !e" '"h $e "n ?el"!"n+/U!u'"nn*" se?es"' -elu' "*"m $"n mem un*"i 'on++"/ Din$in+n*" -e'$i'i "-"s o-o->o-o-

olos/ U!u'"n "n)"n+ u-e'us "$"l"h > 6 5m6 le?"' $i "-"s 62 5m6 -e?"l 26 5m $"n -e?"l$in$in+ 162 5m/ le-"! u-e'us $"l"m !e"$""n isiolo+is "$"l"h "n-e e'sio le!sio/ #ungsi:-em "- mene'im"6 mem e'-"h"n!"n $"n mem?e'i m"!"n o um *"n+ -el"h $i?u"hi/

Bagian$bagian:1/ 9un$us : -e'le-"! $i "-"s mu"'" -u?" u-e'ine2/ &o' us : -e'le-"! $i?"@"h ?"+i"n -u?" u-e'ine3/ &e' i : ?"+i"n ?"@"h !o' us *"n+ men*em i-&e' i ini menem?us $in$in+ "n-e'io' "+in" $"n men)"$i 2:

Po'-io su '" "+in"lisPo'-io "+in"lis 5e' i5is u-e'i

S"lu'"n *"n+ -e'$" "- $"l"m se' i!s $ise?u- !"n"lis se' i!"lis *"n+ $il" isi oleh !elen)"'>!elen)"' -o'"! ?e'sili" $"n ?e' un+si se?"+"i 'ese -"!ulum seminis/ Pin-u s"lu'"n se' i!sse?el"h $"l"m $ise?u- os-ium u-e'i in-e'num $"n in-u $i "+in" $ise?u- os-ium u-e'ie!s-e'num/Ismus "$"l"h ?"+i"n u-e'us "n-"'" se' i!s $"n !o' us u-e'i6 $ili u-i oleh e'i-oneum ise'"le*"n+ mu$"h se!"li $i+ese' $"'i $"s"'n*" "-"u $i+e'"!!"n $i $"e'"h li!" esi!ou-e'in"/Hi&!olo"i u!eru&Se5"'" his-olo+i! $"'i $"l"m !e lu"'6 u-e'us -e'$i'i "-"s:

Tuni5" mu5os" "-"u en$ome-'ium $i !o' us u-e'i $"n en$ose' i!s $i se' i!s u-e'i/En$ime-'ium -e'$i'i "-"s e i-el !u?oi$6 !elen)"'>!elen)"' $"n )"'in+"n $en+"n ?"n*"!

em?uluh $"'"h *"n+ ?e'!elo!>!elo!/ Tuni5" mus5ul"'is "-"u m*ome-'ium *"n+ s"n+"- -e?"l $"n $i?en-u! oleh o-o- olos*"n+ $iso!on+ oleh )"'in+"n i!"-/ L" is"n o-o- olos u-e'us $i se?el"h $"l"m

?e'?en-u! si'!ul"' $"n $i se?el"h lu"' lon+i-u$in"l/ Di "n-"'" !e$u" l" is"n i-u-e'$" "- l" is"n o-o- o?li! ?e'?en-u! "n*"m"n L" is"n se'os"6 *"!ni e'i-oneum is5e'"l

U-e'us -e' i!s"si $"l"m 'on++" el is -e-" i -e' i!s"si $en+"n ?"i! oleh )"'in+"n i!"- $"nli+"men- *"n+ men*o!on+n*"/ Li+"men- *"n+ mem i!s"si u-e'us "$"l"h se?"+"i ?e'i!u-:

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1/ Li+"men-um !"'$in"l 7,"5!en'o$-8u-e'in",e'u "!"n li+"men-um *"n+ men"h"n u-e'us su "*" -i$"! ?"n*"! ?e'+e'"!/ Be')"l"n $"'ise' i!s ?"+i"n !i'i $"n !"n"n !e "'"h os s"5'um/

3/ Li+"men-um 'o-un$um,e'u "!"n li+"men-un *"n+ men"h"n u-e'us $"l"m "n-e le!si/ Be')"l"n $"'i un$us u-e'i !i'i>!"n"n !e $"e'"h in+uin"l

4/ Li+"men-um l"-um

el i!um men+i!u-i -u?" "llo ii/ Be's"m">s"m" !em?"li mel"lui le!sus en"hi o+"s-'i!"/

Aliran li% e

Pem?uluh lim e $"'i un$us u-e'i ?e')"l"n ?e's"m" "'-e'i" o "'i5" $"n men+"li'!"n lim e !eno$i "'" "o'-i5 se-in++i e'-e?'" L1/ Pem?uluh lim e $"'i 5o' us u-e'i $"n se' i!s u-e'i

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?e'mu"$" !e no$i ili"5i in-e'ni $"n no$i ili"5i e!s-e'ni/ Be?e'" " em?uluh lim e men+i!u-ili+"men-um -e'es u-e'i $i $"l"m 5"n"lis in+uin"lis $"n men+"li'!"n 5"i'"n lim e !e no$iin+uin"lis su e' i5i"les/

Iner'a&i

S"'" sim "-is $"n "'"sim "-is ?e'"s"l $"'i le!sus hi o+"s-'i!us in e'io'

3/ Tu$a allo i+ -e'$i'i "-"s:1/ P"'s in-e's-i-i"lis6 *"i-u ?"+i"n *"n+ -e'$" "- $i $in$in+ u-e'us2/ P"'s ismi!"6 me'u "!"n ?"+i"n me$i"l -u?" *"n+ sem i- selu'uhn*"3/ P"'s "m ul"'is6 *"i-u ?"+i"n *"n+ ?e'?en-u! se?"+"i s"lu'"n "+"! le?"'6 -em "- !onse si-e')"$i4/ In un$i?ulum6 *"i-u ?"+i"n u)un+ -u?" *"n+ -e'?u!" !e" '"h "?$omen $"n memili!i

im?'"e

B"+i"n lu"' -u?" $ili u-i oleh e'i-oneum is5e'"l *"n+ me'u "!"n ?"+i"n $"'i li+"men-uml"-um/

4. 'ariu%

,eso "'ium men++"n-un+ o "'ium $i ?"+i"n li+"men-um l"-um !"n"n $"n !i'i/ U!u'"nn*"!u'"n+ le?ih se?es"' i?u )"'i -"n+"n $en+"n u!u'"n "n)"n+ !i'">!i'" 45m6 le?"' $"n -e?"l!i'">!i'" 16 5m/ in++i' "-"sn*" ?e'hu?un+"n $en+"n meso "'ium -em "- $i-emu!"nn*"

em?uluh> em?uluh $"'"h $"n se'"?u->se'"?u- s"'" un-u! o "'ium se$"n+!"n in++i' ?"@"hn*" ?e?"s/ U)un+ o "'ium *"n+ le?ih 'en$"h ?e'hu?un+"n $en+"n u-e'us mel"luili+"men-um o "'ii 'o ium/ B"+i"n li+"men-um l"-um *"n+ -e'le-"! "n-"'" e'le!"-"nmeso "'ium $"n $in$in+ l"-e'"l el is $ise?u- li+"men-um sus enso'ium o "'ii/O "'ium ?i"s"n*" -e'le-"! $i $e "n $in$in+ l"-e'"l el is "$" le!u!"n *"n+ $ise?u- oss"o "'i5"/ 9oss" ini $i?"-"si $i "-"s oleh "'-e'i" $"n en" ili"5" e!s-e'n" se'-" $i ?el"!"n+ oleh"'-e'i" $"n en" ili"5" in-e'n"/

6a&kulari&a&i o'ariu% A'-e'i" o "'i5" *"n+ ?e'"s"l $"'i "o'-" "?$omin"lis se-in++i e'-e?'" lum?"lis 1 en" o "'i5" $e -'" ?e'mu"'" !e en" 5" " in e'io- se$"n+!"n en" o "'i5" sinis-'" !e

en" 'en"lis sinis-'"

Cer&ara anPe's"'" "n o "'ium ?e'"s"l $"'i le!sus "o'-i5us $"n men+i!u-i e')"l"n"n "'-e'i" o "'i5"/

2. KEHAMILAN2.1 Ceru$ahan Ana!o%i Ca#a Keha%ilan

"/ U-e'us

> Be'-"m?"h ?es"' $en+"n en"m?"h"n olume $"n ?e'"- u-e'us 7$"'i 0 +'C10 ml Q 1100 +'Cli-e'8 se?"+"i "$" -"si un-u! mene'im" !eh"mil"n6

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o Pem?es"'"n 'ime' 7"@"l Q 12 m++ +es-"si8o Pem?es"'"n se!un$e' 7G 12 m++ +es-"si8

T"!si'"n e'?es"'"n u-e'us "$" e'"?""n -in++i un$us:

> > -i$"! h"mil C no'm"l : -elu' "*"m 7F 30 +8

> > min++u : -elu' ?e?e!

> > 12 min++u : -elu' "n+s"

> > 1. min++u : e'-en+"h"n sim isis> us"-

> > 20 min++u : in++i' ?"@"h us"-

> > 24 min++u : in++i' "-"s us"-

> > 32 min++u : e'-en+"h"n us"-> * hoi$

> > 3.>42 min++u : 3 s"m "i 1 )"'i ?"@"h * hoi$

> Penin+!"-"n !e!u"-"n $in$in+ u-e'us 7 e'en++"n+"n $"n ene?"l"n sel>sel o-o-6 "!umul"si )"'in+"n i!"- $"n el"s-i56 -e'u-"m" "$" l" is"n o-o- lu"' "!i?"- s-imul"si es-'o+en $"n se$i!i-

'o+es-e'one8/> Pene?"l"n !o' us u-e'i "$" "@"l !eh"mil"n6 -e-" i !emu$i"n "!"n meni is sei'in+ $en+"n

?e'-"m?"hn*" usi" !eh"mil"n6 "$" "!hi' !eh"mil"n !e-e?"l"nn*" h"n*" ?e'!is"' 16 5m ?"h!"n !u'"n+/> ,un5ul -"n$" Piscaseck 7 ene?"l"n u-e'us *"n+ le?ih "$" -em "- e'le!"-"n l"sen-"8/> ,un5ul -"n$" %egar 7hi e'-'o i ismus u-e'i men)"$i le?ih "n)"n+ $"n lun"!8/> ,un5ul lin+!"'"n 'e-'"!si isiolo+is 7?"-"s se+men "-"s *+ -e?"l $+n se+men ?"@"h *+-i is8/> Te')"$i !on-'"!si Bra&ton %icks 7$"'i ?ul"n e'-"m" $"n menu'un hin++" ?ul"n -e'"!hi'6n"mun menin+!"- "$" s"-u "-"u $u" min++u se?elum e's"lin"n6 h"l ini e'"- !"i-"nn*"$en+"n menin+!"-n*" )uml"h 'ese -o' o!si-osin $"n +" )un5-ion $i "n-"'" sel>selen$ome-'ium8/

?/ Se' i!s> Se' i!s li'ide 7lun"! $"n !e?i'u"n8 "!i?"- hi e' "s!ul"'is"si/> Hi e'-'o i $"n hi e' l"si !elen)"' se' i!s/> (emodeling se' i!s 7 en+"!-i "n !ol"+en"se in-'">e!s-'" se5ul"' un-u! melem"h!"n m"-'i!s!ol"+en "+"' e's"lin"n $" "- ?e'l"n+sun+8/

5/ O "'ium> Pen+hen-i"n 'oses o ul"si $"n em"-"n+"n oli!el 7 "se is-i'"h"-8

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> Ko' us lu-eum ?e' un+si sel"m" 11 min++u !eh"mil"n s?+ en+h"sil 'o+es-e'onese?elum l"sen-" -e'?en-u!/> Se!'esi 'el"!sin oleh !o' us lu-eum6 $esi$u"6 l"sen-"6 $"n h"-i/ A!si ?iolo+i u-"m"n*""$"l"h $"l"m 'oses 'emo$elin+ )"'in+"n i!"- "$" s"lu'"n 'e 'o$u!si6 *"n+ !emu$i"n "!"n

men+"!omo$"si !eh"mil"n $"n !e?e'h"sil"n e's"lin"n/ Pe'"nn*" ?elum $i!e-"hui se5"'"men*elu'uh6 -e-" i $i!e-"hui mem un*"i e e! "$" e'u?"h"n s-'u!-u' ?io!imi" se' i!s $"n!on-'"!si miome-'ium *"n+ "!"n ?e'im li!"si "$" !eh"mil"n 'e-e'm/

$/ "+in" Pe'ineum> Penin+!"-"n "s!ul"'is"si $"n h* e'emi" "$" !uli- $"n o-o->o-o- e'ineum $"n ul "6sehin++" "+in" -e'lih"- !eun+u>un+u"n 7 Chadwick sign 8 "!i?"- en+"'ih ho'mone es-'o+en$"n 'o+es-e'one/> Din$in+ "+in" men+"l"mi enin+!"-"n !e-e?"l"n mu!os"6 men+en$o'n*" )"'in+"n i!"-6$"n hi e'-'o i sel o-o- olos/ Pe'u?"h"n men+"!i?"-!"n $in$in+ "+in" ?e'-"m?"h "n)"n+$"n si" se?"+"i )"l"n l"hi'/> P" il" mu!os" "!"n men+"l"mi hi e'-'o i $en+"n +"m?"'"n se e'-i "!u se "-u/> Se!'esi "+in" menin+!"- $en+"n 5"i'"n ?e'@"'n" !e u-ih"n6 mene?"l6 $"n $en+"n H 36 Q. *"n+ me'u "!"n h"sil $"'i enin+!"-"n 'o$u!si "s"m l"!-"- +li!o+en *"n+ $ih"sil!"n olehe i-el "+in" se?"+"i "!si $"'i lactobacillus acidophilus)

e/ Kuli-> ,un5ul striae gra'idarum 7 e'u?"h"n @"'n" men)"$i !eme'"h"n6 !us"m "$" $in$in+

e'u-6 "*u$"'" $"n "h"8/

> ,un5ul Linea nigra 7+"'is e'-en+"h"n e'u- "!"n ?e'u?"h men)"$i hi-"m !e5o!l"-"n8/>Chloasma * melasma gra'idarum 7 e'u?"h"n @"'n" !ehi-"m"n "$" @")"h $"n lehe'8/> Pi+men-"si *"n+ ?e'le?ih"n "$" "'eol" $"n $"e'"h +eni-"l/

/ P"*u$"'"> P"*u$"'" men)"$i le?ih lun"! 7 "$" "@"l !eh"mil"n8 $"n !emu$i"n mene+"n+ "!i?"-

en+"'uh es-'o+en/> P"*u$"'" mem?es"' "!i?"- h* e' l"si" sis-em $u!-us $"n )"'in+"n in-e's-isi"l "*u$"'" oleh

en+"'uh es-'o+en $"n ho'mone l"!-o+eni! l"sen-"/> Kolus-'um $" "- !elu"' 7se-el"h ?ul"n e'-"m"8/> Ni le mem?es"'6 hi-"m6 -e+"!/> Te')"$i hi e' i+men-"si !uli- se'-" hi e'-'o i !elen)"' ,on-+ome'*6 -e'u-"m" $"e'"h "'eol"$"n " ill" "!i?"- en+"'uh mel"no o'/> Ai' susu -i$"! ?is" !elu"' 7"!i?"- prolactin inhibiting hormone 8/

Peningkatan berat badan selama hamil No'm"l ?e'"- ?"$"n menin+!"- se!i-"' .>1. !+6 -e'u-"m" $"'i e'-um?uh"n isi !onse si $"n

olume ?e'?"+"i o'+"n C 5"i'"n in-'"u-e'in/ Be'"- )"nin F 2/ >3/ !+6 ?e'"- l"sen-" F 0/ !+65"i'"n "mnion F 1/0 !+6 ?e'"- u-e'us F 1/0 !+6 en"m?"h"n olume si'!ul"si m"-e'n"l F 1/!+6 e'-um?uh"n m"mm"e F 1 !+6 enum u!"n 5"i'"n in-e's-isi"l $i el is $"n e!s-'emi-"s F

1/0>1/ !+/

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'ula&iO ul"si $i e'lu!"n un-u! -e')"$in*" em?u"h"n *"n+ no'm"l:> O um h"'us !elu"' $"'i o "'ium $"n m"su! !e -u?" "lo i> O um *"n+ -i$"! $i?u"hi $i!elilin+i oleh on" elu5i$"

> Oosi- ini -el"h men*eles"i!"n em?el"h"n meiosis *"n+ e'-"m" $"n men+h"sil!"n ?"$"n ol"' I/

Ce%$uahanPem?u"h"n ?i"s"n*" -e')"$i $"l"m 24 )"m se-el"h o ul"si "$" 1C3 -u?" "lo i *"n+ mele!"-

"$" o "'ium7"m ul"8:> S e'm" ene-'"si !e $"l"m on" elu5i$" $"n mem usi!"n mem?'"n l"sm"n*" $en+"nmem?'"n l"sm" o um/> In-i s e'm" $"n isi sel *"n+ l"inn*" m"su! !e $"l"m si-o l"sm" -elu'/> Bil" -e')"$i em?u"h"n o um "!"n se+e'" men*eles"i!"n meiosis II $"n men+h"sil!"n

?"$"n ol"' -"m?"h"n/

Crei% lan!a&i> Telu' *"n+ su$"h $i?u"hi -e-" $i "m ul" sel"m" 0 )"m se-el"h 'u -u' oli!el $"n mele@"-iismus -u?" "lo i sel"m" 10 )"m/> Telu' *"n+ su$"h $i?u"hi mem?"+i men)"$i ?en-u! ?l"s-ome' *"n+ mul-isel> Bl"s-ome' mele@"-i -u?" "lo i m"su! !e 'on++" u-e'us/> Em?'io ?e'!em?"n+ men)"$i ?l"s-osi- *"n+ men+" un+ se5"'" ?e?"s $"l"m 5" umen$ome-'ium %0> 1 0 )"m se-el"h !onse si/ 7lih"- -"?el 8

I% lan!a&i> P"$" h"'i !e s"m "i . e'!em?"n+"n 6 ?l"s-osi- menem el "$" en$ome-'ium $en+"n

?"n-u"n mole!ul "$hesi *"n+ -e'$" "- "$" e'mu!""n en$ome-'ium/> Se-el"h e'len+!e-"n6 en$ome-'ium ?e' 'oli e'"si $ise!i-"' ?l"s-osi-/

Cla&en!a&i> Sel"m" min++u !e>2 6 sel> sel $i?"+i"n lu"' m"ss" sel ?e'$i e'ensi"si men)"$i -'o o?l"s-/> L" is"n -'o o?l"s-i! mem?en-u! ?"-"s "@"l "n-"'" em?'io $"n en$ome-'ium/> T'o o?l"s- *"n+ "lin+ $e!"- $en+"n miome-'ium mem?en-u! 5"!'"m l"sen-"6 -'o lo?l"s-*"n+ l"in mem?en-u! mem?'"n !o'ioni!/

Co&! I% lan!a&i> En$ome-'iumC in++i' u-e'us sel"m" !eh"mil"n $ise?u- $esi$u"/> Sel $"'"h me'"h i?u -"m "! $"l"m l"!un" -'o o?l"s-i! "$" min++u !e$u" os- !onse si

PlasentaDi"-"s -'imes-e' !e$u" $"n -'imes-e' !e-i+" l"sen-" sel"n)u-n*" men*esu"i!"n $i'i/ Pl"sen-"me'u "!"n en+h"sil ho'mon s-e'oi$ 'ime'6 se-el"h !eh"mil"n -u)uh min++u/+uplai ,arah

Ali'"n "$" "'-e'i "'!u"-" $"n '"$i"l sel"m" !eh"mil"n no'm"l -in++i $en+"n 'esis-ensi'en$"h 7'esis-ensi menu'un se-el"h 20 min++u8/

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MIN-- KE31 mm/ Ke "l"n*"mem?ul"- $"n @")"h olos !e!"n"!>!"n"!"n mul"i -"m "! n*"-" $en+"n -e'-"'i!n*" ?"+i"n"n-"'" $"hi $"n "n+!"l hi$un+ !e "'"h $"l"m6 hin++" !i"n mem e')el"s 5i!"l>?"!"l

!em"n5un+"n hi$un+ si )"nin/ L"n+i->l"n+i- mulu- mul"i -e'?en-u!6 ?e+i-u )u+" !elo "! m"-"se'-" $"un -elin+" lu"'/ Se5"'" !eselu'uh"n m"!in men*e'u "i ?"*i $en+"n -"!si'"n ?e'"-se!i-"' +'"m/ ,es!i m"sih lem"h6 e'mul""n $"'i '"n+!" -u?uh se5"'" !eselu'uh"n su$"h'"m un+ $"n len+!" -e'?en-u! $"l"m min++u ini/ Semu" o'+"n -u?uh )u+" mul"i ?e!e')"6mes!i ?elum sem u'n"/ Semis"l o-"! *"n+ mul"i men+i'im sin*"lC e'in-"h !e o'+"n>o'+"n-u?uh "-"u h"-i *"n+ mul"i mem 'o$u!si sel>sel $"'"h/ Tu?uh *"n+ 'in+!ih ini un mul"i ?is"

?e'+e'"! se5"'" -"! -e'"-u'6 *"n+ )i!" $i)uml"h!"n '"-">'"-" se?"n*"! .0 !"li +e'"!"n $"l"mse)"m/

2. A$or!u&

Pen++u+u'"n !"n$un+"n "-"u "?o'si "-"u "?o'-us menu'u-:

"8 ,e$is : "?o'-us "$"l"h ?e'"!hi'n*" !eh"mil"n mel"lui 5"'" " " un se?elum )"nin m"m u ?e'-"h"n hi$u "$" usi" !eh"mil"n se?elum 20 min++u $i$"s"'!"n "$" -"n++"l h"'i e'-"m" h"i$ no'm"l -e'"!hi' "-"u ?e'"- )"nin !u'"n+ $"'i 00 +'"m 7 O?s-e-'i (illi"ms6200.8/

?8 K"mus Bes"' B"h"s" In$onesi" : -e')"$i !e+u+u'"n )"nin6 mel"!u!"n "?o'-us 7$en+"nsen+")" !"'en" -i$"! men+in+in!"n ?"!"l ?"*i *"n+ $i!"n$un+ i-u8/

58 Ke+u+u'"n "$"l"h e+elu"'"n h"sil !onse si se?elum )"nin $" "- hi$u $i lu"' !"n$un+"n7Rus-"m ,u5h-"'6 1%% 8/

$8 Is-il"h "?o'-us $i "!"i un-u! menun)u!!"n en+elu"'"n h"sil !onse si se?elum )"nin $" "-hi$u $i lu"' !"n$un+"n/ S"m "i s""- ini )"nin *"n+ -e'!e5il6 *"n+ $il" o'!"n $" "- hi$u$i lu"' !"n$un+"n6 mem un*"i ?e'"- ?"$"n 2% +'"m @"!-u l"hi'/ A!"n -e-" i6 !"'en"

)"'"n+n*" )"nin *"n+ $il"hi'!"n $en+"n ?e'"- ?"$"n $i ?"@"h 00 +'"m $" "- hi$u -e'us6m"!" "?o'-us $i-en-u!"n se?"+"i en+"!hi'"n !eh"mil"n se?elum )"nin men5" "i ?e'"-

00 +'"m "-"u !u'"n+ $"'i 20 min++u 7S"'@ono6 200 8/

2.2 E!iolo"i

A?o'-us *"n+ -e')"$i "$" min++u>min++u e'-"m" !eh"mil"n umumn*" $ise?"?!"n oleh"!-o' o'ofetal" "$" min++u>min++u ?e'i!u-n*" 711 Q 12 min++u86 "?o'-us *"n+ -e')"$i

$ise?"?!"n oleh "!-o' maternal 7S"*i$un6 20018/

9"!-o' o'ofetal :

Peme'i!s""n US= )"nin $"n his-o "-olo+is sel"n)u-n*" menun)u!!"n ?"h@" "$" 0M!"sus6 o um *"n+ -el"h $i?u"hi +"+"l un-u! ?e'!em?"n+ "-"u -e')"$i m"l o'm"si "$"-u?uh )"nin/ P"$" 40M !"sus6 $i!e-"hui ?"h@" l"-"' ?el"!"n+ !e)"$i"n "?o'-us "$"l"h

kelainan chromosomal) P"$" 20M !"sus6 -e'?u!-i "$"n*" kegagalan trofoblast un-u!mel"!u!"n im l"n-"si $en+"n "$e!u"-/

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9"!-o' maternal :

Se?"n*"! 2M e'is-i@" "?o'-us $ise?"?!"n oleh "$"n*" en*"!i- sis-emi! m"-e'n"l7 systemic lupus erythematosis 8 $"n in e!si sis-emi! m"-e'n"l -e'-en-u l"inn*"/ M e'is-i@""?o'-us ?e'!"i-"n $en+"n abnormalitas uterus 7 !el"in"n uterus kongenital" mioma uteri

submukosa" inkompetensia ser'ik 8/ Te'$" "- $u+""n ?"h@" m"s"l"h si!olo+is memili!i e'"n"n ul" $en+"n !e)"$i"n "?o'-us mes!i un suli- un-u! $i?u!-i!"n "-"u $il"!u!"n enil"i"n l"n)u-"n/

Pen*e?"? "?o'-us $" "- $i?"+i men)"$i 3 "!-o' *"i-u:

1/ 9"!-o' )"nin

9"!-o' )"nin en*e?"? !e+u+u'"n "$"l"h !el"in"n +ene-i!6 $"n ini -e')"$i "$" 0M>.0M!"sus !e+u+u'"n/

2/ 9"!-o' i?u:"/ Kel"in"n en$o!'in 7ho'mon"l8 mis"ln*" !e!u'"n+"n -i'oi$6 !en5in+ m"nis/

?/ 9"!-o' !e!e?"l"n 7imunolo+i86 mis"ln*" "$" en*"!i- lu us6 An-i hos holi i$s*n$'ome/

5/ In e!si6 $i$u+" "!i?"- ?e?e'" " i'us se e'-i 5"5"' "i'6 5"m "! )e'm"n6 -o!so l"sm" 6he' es6 !l"mi$i"/

$/ Kelem"h"n o-o- lehe' '"him

e/ Kel"in"n ?en-u! '"him/

3/ 9"!-o' A*"h: !el"in"n !'omosom $"n in e!si s e'm" $i$u+" $" "- men*e?"?!"n "?o'-us/

Sel"in 3 "!-o' $i "-"s6 "!-o' en*e?"? l"in $"'i !eh"mil"n "?o'-us "$"l"h:

1/ 9"!-o' +ene-i!

Se!i-"' M "?o'-us -e')"$i !"'en" "!-o' +ene-i!/ P"lin+ se'in+ $i-emu!"nn*" !'omosom-'isomi $en+"n -'isomi 1./ Pen*e?"? *"n+ "lin+ se'in+ menim?ul!"n "?o'-us s on-"n"$"l"h "?no'm"li-"s !'omosom "$" )"nin/ Le?ih $"'i .0M "?o'-us s on-"n *"n+ -e')"$i

"$" -'imes-e' e'-"m" menun)u!!"n ?e?e'" " -i e "?no'm"li-"s +ene-i!/ A?no'm"li-"s+ene-i! *"n+ "lin+ se'in+ -e')"$i "$"l"h "neu loi$i 7"?no'm"li-"s !om osisi !'omosom85on-ohn*" -'isomi "u-osom *"n+ men*e?"?!"n le?ih $"'i 0M "?o'-us s on-"n/ Poli loi$imen*e?"?!"n se!i-"' 22M $"'i "?o'-us s on-"n *"n+ -e')"$i "!i?"- !el"in"n !'omosom/

Se!i-"' 3> M "s"n+"n *"n+ memili!i 'i@"*"- "?o'-us s on-"n *"n+ ?e'ul"n+ s"l"h s"-u$"'i "s"n+"n -e'se?u- mem?"@" si "- !'omosom *"n+ "?no'm"l/ I$en-i i!"si $" "-$il"!u!"n $en+"n eme'i!s""n !"'io-i e $im"n" ?"h"n eme'i!s""n $i"m?il $"'i $"'"h-e i "s"n+"n -e'se?u-/ Te-" i -en-un*" eme'i!s""n ini ?elum ?e'!em?"n+ $i In$onesi"$"n ?i"*"n*" 5u!u -in++i/

2/ 9"!-o' "n"-omi

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9"!-o' "n"-omi !o+eni-"l $"n $i$" "- e'n"h $il" o'!"n -im?ul "$" 10>1 M @"ni-"$en+"n "?o'-us s on-"n *"n+ 'e!u'en/

18 Lesi "n"-omi !o+eni-"l *"i-u !el"in"n $u!-us ,ulle'i"n 7u-e'us ?e'se -"8/ Du!-usmulle'i"n ?i"s"n*" $i-emu!"n "$" !e+u+u'"n -'imes-e' !e$u"/

28 Kel"in"n !o+eni-"l "'-e'i u-e'in" *"n+ mem?"h"*"!"n "li'"n $"'"h en$ome-'ium/

38 Kel"in"n *"n+ $i$" "- mis"ln*" "$hesi in-'"u-e'in 7s*ne5hi"86 leimiom"6 $"nen$ome-'iosis/

A?no'm"li-"s "n"-omi m"-e'n"l *"n+ $ihu?un+!"n $en+"n !e)"$i"n "?o'-us s on-"n *"n+ ?e'ul"n+ -e'm"su! in!om e-ensi se' i!s6 !on+eni-"l $"n $e e! u-e'us *"n+ $i$" "-!"n7"5 ui'e$8/ ,"l o'm"si !on+eni-"l -e'm"su! usi $u!-us ,ulle'i *"n+ in!om li- *"n+$" "- men*e?"?!"n u-e'us uni!o'nus6 ?i!o'nus "-"u u-e'us +"n$"/ De e! "$" u-e'us *"n+"5 ui'e$ *"n+ se'in+ $ihu?un+!"n $en+"n !e)"$i"n "?o'-us s on-"n ?e'ul"n+ -e'm"su!

e'len+!e-"n u-e'us "-"u sine!i" $"n leiomiom"/ A$"n*" !el"in"n "n"-omis ini $" "-$i!e-"hui $"'i eme'i!s""n ul-'"sono+'" i 7US=86 his-e'os"l in+o+'" i 7HS=86 his-e'os!o i$"n l" "'os!o i 7 'ose$u' $i"+nos-i!8/

Peme'i!s""n *"n+ $" "- $i"n)u'!"n !e "$" "sien ini "$"l"h eme'i!s""n US= $"n HS=/D"'i eme'i!s""n US= se!"li+us )u+" $" "- men+e-"hui "$"n*" su"-u miom" -e'u-"m"

)enis su?mu!os"/ ,iom" su?mu!os" me'u "!"n s"l"h s"-u "!-o' me!"ni! *"n+ $" "-men++"n++u im l"n-"si h"sil !onse si/ ;i!" -e'?u!-i "$"n*" miom" "$" "sien ini m"!"

e'lu $ie!s lo'"si le?ih )"uh men+en"i !eluh"n $"n h"'us $i "s-i!"n " "!"h miom" ini ?e'hu?un+"n l"n+sun+ $en+"n "$"n*" ROB "$" "sien ini/ H"l ini en-in+ !"'en" miom"*"n+ men++"n++u mu-l"! $il"!u!"n o e'"si/

3/ 9"!-o' en$o!'in:

"/ 9"!-o' en$o!'in ?e' o-ensi"l men*e?"?!"n "?o'si "$" se!i-"' 10>20 M !"sus/

?/ Insu isiensi "se lu-e"l 7 un+si 5o' us lu-eum *"n+ "?no'm"l $en+"n -i$"! 5u!u n*" 'o$u!si 'o+es-e'on8/

5/ Hi o-i'oi$isme6 hi o 'ol"!-inemi"6 $i"?e-es $"n sin$'om oli!is-i! o "'ium me'u "!"n"!-o' !on-'i?usi "$" !e+u+u'"n/

Ken"i!"n insi$en "?o'-us ?is" $ise?"?!"n oleh hi e'-i'oi$ismus6 $i"?e-es meli-us $"n$e isisensi 'o+es-e'on/ Hi o-i'oi$ismus -"m "!n*" -i$"! ?e'!"i-"n $en+"n !en"i!"ninsi$en "?o'-us 7Su-he'l"n$ $!!6 1% 18/ Pen+en$"li"n +lu!os" *"n+ -i$"! "$e!u"- $" "-men"i!!"n insi$en "?o'-us 7Su-he'l"n$ $"n P'i-5h"'$6 1% .8/ De isiensi 'o+es-e'on!"'en" !u'"n+n*" se!'esi ho'mon -e'se?u- $"'i !o' us lu-eum "-"u l"sen-"6 mem un*"i!"i-"n $en+"n !en"i!"n insi$en "?o'-us/

K"'en" 'o+es-e'on ?e' un+si mem e'-"h"n!"n $esi$u"6 $e isiensi ho'mon -e'se?u- se5"'"-eo'i-is "!"n men++"n++u nu-'isi "$" h"sil !onse si $"n $en+"n $emi!i"n -u'u- ?e' e'"n

$"l"m e'is-i@" !em"-i"nn*"/4/ 9"!-o' in e!si

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In e!si -e'm"su! in e!si *"n+ $i"!i?"-!"n oleh TOR& 7To!so l"sm"6 Ru?ell"6&*-ome+"lo i'us8 $"n m"l"'i"/ In e!si in-'"u-e'in se'in+ $ihu?un+!"n $en+"n "?o'-uss on-"n ?e'ul"n+/ O'+"nisme>o'+"nisme *"n+ se'in+ $i$u+" se?"+"i en*e?"? "n-"'" l"in&hl"m*$i"6 U'e" l"sm"6 ,*5o l"sm"6 &*-ome+"lo i'us6 Lis-e'i" mono5*-o+enes $"n

To o l"sm" +on$ii/ In e!si "!-i *"n+ men*e?"?!"n"?o'-us s on-"n ?e'ul"n+ m"sih ?elum $" "- $i?u!-i!"n/ N"mun un-u! le?ih mem"s-i!"n en*e?"?6 $" "- $il"!u!"n eme'i!s""n !ul-u' *"n+ ?"h"nn*" $i"m?il $"'i 5"i'"n "$" se' i!"l $"n en$ome-'i"l/

/ 9"!-o' imunolo+i

Te'$" "- "n-i?o$i!"'$ioli i$ *"n+ men+"!i?"-!"n em?e!u"n $"'"h $i?el"!"n+ "'i>"'isehin++" men+"!i?"-!"n !em"-i"n )"nin !"'en" !u'"n+n*" "li'"n $"'"h $"'i "'i>"'i-e'se?u-/ 9"!-o' imunolo+is *"n+ -el"h -e'?u!-i si+ni i!"n $" "- men*e?"?!"n "?o'-uss on-"n *"n+ ?e'ul"n+ "n-"'" l"in: "n-i?o$i "n-inu!le"'6 "n-i!o"+ul"n lu us $"n "n-i?o$i5"'$ioli in/ A$"n*" en"n$" ini mes!i un +e)"l" !linis -i$"! -"m "! $" "- men*e?"?!"n"?o'-us s on-"n *"n+ ?e'ul"n+/ In!om "-i?ili-"s +olon+"n $"'"h A6 B6 O6 $en+"n 'e"!si"n-i+en "n-i?o$i $" "- men*e?"?!"n "?o'-us ?e'ul"n+6 !"'en" ele "s"n his-"minmen+"!i?"-!"n "so$il"-"si $"n enin+!"-"n '"+ili-"s !" ile'/

./ Pen*"!i-> en*"!i- !'onis *"n+ melem"h!"n

P"$" "@"l !eh"mil"n6 en*"!i-> en*"!i- !'onis *"n+ melem"h!"n !e"$""n i?u6 mis"ln*" en*"!i- -u?e'!ulosis "-"u !"'sinom"-osis )"'"n+ men*e?"?!"n "?o'-us se?"li!n*" "sien en*"!i- -e'se?u- se'in+ menin++"l $uni" -"n " mel"hi'!"n/ A$"n*" en*"!i- !'onis7$i"?e-es meli-us6 hi e'-ensi !'onis6 en*"!i- li e'C +in)"l !'onis8 $" "- $i!e-"hui le?ih

men$"l"m mel"lui "n"mnes" *"n+ ?"i!/ Pen-in+ )u+" $i!e-"hui ?"+"im"n" e')"l"n"n en*"!i-n*" )i!" mem"n+ e'n"h men$e'i-" in e!si ?e'"-6 se e'-i " "!"h -el"h $i-e'" i$en+"n -e "- $"n "$e!u"-/ Un-u! e!s lo'"si !"us"6 $" "- $i!e')"!"n ?e?e'" " eme'i!s""nl"?o'"-o'ium se e'-i

eme'i!s""n +ul" $"'"h6 -es un+si h"-i $"n -es un+si +in)"l un-u! menil"i " "!"h "$"+"n++u"n un+si he "' $"n +in)"l "-"u $i"?e-es meli-us *"n+ !emu$i"n $" "-menim?ul!"n +"n++u"n "$" !eh"mil"n se e'-i e's"lin"n 'em"-u'/

/ 9"!-o' Nu-'isi

,"lnu-'isi umum *"n+ s"n+"- ?e'"- memili!i !emun+!in"n "lin+ ?es"' men)"$i 'e$is osisi "?o'-us/ ,es!i un $emi!i"n6 ?elum $i-emu!"n ?u!-i *"n+ men*"-"!"n ?"h@"$e isisensi s"l"h s"-uC semu" nu-'ien $"l"m m"!"n"n me'u "!"n su"-u en*e?"? "?o'-us*"n+ en-in+/

/ O?"->o?"- 'e!'e"sion"l $"n -o!sin lin+!un+"n/

Pe'"n"n en++un""n o?"->o?"-"n 'e!'e"sion"l -e'-en-u *"n+ $i"n++" -e'"-o+eni! h"'us$i5"'i $"'i "n"mnes" se e'-i -em?"!"u $"n "l!ohol6 *"n+ ?e' e'"n !"'en" )i!" "$"mun+!in h"l ini me'u "!"n s"l"h s"-u *"n+ ?e' e'"n/

%/ 9"!-o' si!olo+is/

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Di?u!-i!"n ?"h@" "$" hu?un+"n "n-"'" "?o'-us *"n+ ?e'ul"n+ $en+"n !e"$""n men-"l"!"n -e-" i ?elum $" "- $i)el"s!"n se?"?n*"/ !"$"n+

l"sen-" m"sih -e'-in++"l $"l"m u-e'us sehin++" men*e?"?!"n +"n++u"n !on-'"!si u-e'us $"n-e')"$i e'$"'"h"n e' "+in"m *"n+ ?"n*"!/ Pe'$"'"h"n umumn*" -i$"! -e'l"lu ?"n*"!n"mun '"s" n*e'i le?ih menon)ol/ D"'i en)el"s"n $i "-"s )el"s ?"h@" "?o'-us $i-"n$"i $en+"n"$"n*" e'$"'"h"n u-e'us $"n n*e'i $en+"n in-ensi-"s ?e'"+"m 7P'"@i'oh"'$)o6 20028/

2.4 Kla&i ika&i A$or!u&

A?o'-us $" "- $i?"+i "-"s $u" +olon+"n *"i-u:

,enu'u- -e')"$in*" $i?e$"!"n "-"s:

1/ A?o'-us s on-"n *"i-u "?o'-us *"n+ -e')"$i $en+"n sen$i'in*" -"n " $isen+")" "-"u $en+"n-i$"! $i$"hului "!-o'> "!-o' me!"nis "-"u me$isin"lis6 sem"-"m"-" $ise?"?!"n oleh

"!-o'> "!-o' "l"mi"h/

2/ A?o'-us 'o o!"-us 7in$u!si "?o'-us8 "$"l"h "?o'-us *"n+ $isen+")" -"n " in$i!"si me$is6 ?"i! $en+"n mem"!"i o?"->o?"-"n m"u un $en+"n "l"->"l"-/ A?o'-us ini -e'?"+i l"+imen)"$i:

39


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41/50

#. Inhi$i&i 'a"u&+ h"m i' sel"lu -e')"$i "$" -in$"!"n "?o'-us *"n+ $il"!u!"n -"n " "nes-esi "$" i?u $"l"m !e"$""n s-'ess6 +elis"h6 $"n "ni!/ H"l ini $" "- -e')"$i "!i?"- "l"- *"n+$i+un"!"n "-"u sun-i!"n se5"'" men$"$"! $en+"n 5"i'"n *"n+ -e'l"lu "n"s "-"u -e'l"lu$in+in/

e. Kera8unan o$a!7 a! a$or!i'u%+ -e'm"su! !"'en" "nes-esi"/ An-ise -i! lo!"l se e'-iKmnO4 e!"-6 A+NO36 K>Klo'"-6 ;o$ium $"n Su?lim"- $" "- men+"!i?"-!"n 5e$e'"*"n+ he?"- "-"u !em"-i"n/ Demi!i"n ul" o?"->o?"-"n se e'-i !in" "-"u lo+"m ?e'"-/Peme'i!s""n "$"n*" ,e->H?6 eme'i!s""n his-olo+i! $"n -o!si!ol+i! s"n+"- $i e'lu!"nun-u! mene+"!!"n $i"+nosis/

. In ek&i #an &e &i&.Kom li!"si ini -i$"! se+e'" -im?ul "s5" -in$"!"n -e-" i meme'lu!"n@"!-u/

". Lain


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gonorrhea" chlamydia" syphilis"trichomoniasis" chancroid" herpes genital 6 in e!si humanimmunodeficiensy 'irus 7HI 8 $"n hepatitis B / %-. $"n syphilis )u+" $" "- $i-ul"'!"n $"'i i?u!e "n"!n*" sel"m" !eh"mil"n $"n !el"hi'"n6 $"n )u+" mel"lui $"'"h se'-" )"'in+"n -u?uh7(HO6200%8/

3.2 E!iolo"i Cen(aki! Menular Sek&ual,enu'u- H"n$s iel$ 720018 $"l"m &hium"n 7200%86 Pen*"!i- menul"' se!su"l $" "-

$i!l"si i!"si!"n ?e'$"s"'!"n "+en en*e?"?n*"6 *"!ni:"/ D"'i +olon+"n ?"!-e'i6 *"!ni /eisseria gonorrhoeae" Treponema pallidum"

Chlamydia trachomatis" !reaplasma urealyticum"Mycoplasma hominis" Gardnerella'aginalis" +almonella sp" +higella sp" Campylobacter sp" +treptococcus group B"

Mobiluncus sp) ?/ D"'i +olon+"n 'o-o o"6 *"!ni Trichomonas 'aginalis" 0ntamoeba histolytica"

Giardia lamblia"5/ D"'i +olon+"n i'us6 *"!ni %uman -mmunodeficiency .irus1tipe 2 dan 34" %erpes

+imple& .irus 1tipe 2 dan 34" %uman papiloma .irus"Cytomegalo'irus" 0pstein$barr'irus" Molluscum contagiosum 'irus"

$/ D"'i +olon+"n e!-o "'"si-6 *"!ni Phthirus pubis $"n +arcoptes scabei

3.3 Cenularan Cen(aki! Menular Sek&ual,enu'u- K"'"n+ T"'un" 7200186 sesu"i $en+"n se?u-"nn*" 5"'" enul"'"n Pen*"!i-

,enul"' Se!su"l ini -e'u-"m" mel"lui hu?un+"n se!su"l *"n+ -i$"! -e'lin$un+i6 ?"i! e' "+in"l6 "n"l6 m"u un o'"l/ &"'" enul"'"n l"inn*" se5"'" e'in"-"l6 *"i-u $"'i i?u !e

?"*in*"6 ?"i! sel"m" !eh"mil"n6 s""- !el"hi'"n "-"u un se-el"h l"hi'/ Bis" mel"lui -'"ns use$"'"h "-"u !on-"! l"n+sun+ $en+"n 5"i'"n $"'"h "-"u 'o$u! $"'"h/ D"n )u+" ?is" mel"lui

en++un""n "!"i"n $"l"m "-"u h"n$u! *"n+ -el"h $i "!"i en$e'i-" Pen*"!i- ,enul"'Se!su"l7P,S8/

S"l"h s"-u "!i?"- *"n+ $i-im?ul!"n oleh "!-i i-"s se!s *"n+ !u'"n+ seh"- "$"l"hmun5uln*" en*"!i- menul"' se!su"l/ Penul"'"n en*"!i- ini ?i"s"n*" -e')"$i !"'en"se'in+n*" seseo'"n+ mel"!u!"n hu?un+"n se!su"l $en+"n ?e'+"n-i>+"n-i "s"n+"n/ Bis" )u+"!"'en" mel"!u!"n hu?un+"n se!su"l $en+"n o'"n+ *"n+ se?elumn*" su$"h -e'!en" en*"!i-ini/ 7A)en Di"n"@"-i6 20038/

Sel"in i-u6 -e'$" "- 'en-"n+ !ein-im"n !on-"! -u?uh *"n+ $" "- menul"'!"n P,S-e'm"su! 5ium"n6 hu?un+"n se!su"l6 hu?un+"n se!su"l mel"lui "nus6 !unilin+us6 "nilin+us6

el"sio6 $"n !on-"! mulu- "-"u +eni-"l $en+"n "*u$"'"/ 7Benson "n$ Pe'noll6 200%8,enu'u- Somelus 7200 86 &"'" l"in seseo'"n+ $" "- -e'-ul"' P,S )u+" mel"lui :

1. Darah. D"'i -"ns usi $"'"h *"n+ -e'in e!si6 men++un"!"n )"'um sun-i! ?e's"m"6 "-"u ?en$" -")"m l"inn*" !e ?"+i"n -u?uh un-u! men++un"!"n o?"- "-"u mem?u"- -"-o/

2. I$u ha%il ke a#a $a(in(a. Penul"'"n sel"m" !eh"mil"n6 sel"m" 'oses !el"hi'"n/Se-el"h l"hi'6 HI ?is" menul"' mel"lui men*usui/

3. Her e& $" "- menul"' mel"lui sen-uh"n !"'en" en*"!i- he' es ini ?i"s"n*" -e'$" "-lu!">lu!" *"n+ $" "- menul"' ?il" !i-" -e'sen-uh6 mem"!"i h"n$u! *"n+ lem?"? *"n+

$i "!"i oleh o'"n+ en$e'i-" he' es/

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4. Ta!o #an !in#ik. Pem?u"-"n -"-o $i ?"$"n6 -in$i!6 "-"u en++un""n n"'!o?" mem?e'isum?"n+"n ?es"' $"l"m enul"'"n HI CAIDS/ Se)"! 20016 em"!"i"n )"'um sun-i!*"n+ -i$"! "m"n men$u$u!i "n+!" le?ih $"'i 1 M 5"'" enul"'"n HI CAIDS/

3.4 ran"< ran" Gan" Bere&iko Tin""i Terkena CMSSe-i" o'"n+ ?is" -e'-ul"' I,S/ O'"n+ *"n+ "lin+ ?e'isi!o -e'!en" P,S "$"l"h o'"n+*"n+ su!" ?e'+"n-i "s"n+"n se!su"l $"n o'"n+ *"n+ @"l"u un se-i" "$" s"-u "s"n+"nn"mun "s"n+"n -e'se?u- su!" ?e'+"n-i>+"n-i "s"n+"n se!su"l/ Ke?"n*"!"n *"n+ -e'!en"I,S ?e'usi" 1 Q 2% -"hun6 -" i "$" ul" ?"*i *"n+ l"hi' mem?"@" I,S !"'en" -e'-ul"' $"'ii?un*"/,enu'u- A'i" P'"n"-" 7201086 *"n+ -e'+olon+ !elom o! 'esi!o -in++i -e'!en" P,S "$"l"h :> Usi"

20 Q 34 -"hun "$" l"!i Q l"!i 1. Q 24 -"hun "$" @"ni-" 20 Q 24 -"hun "$" !e$u" )enis !el"min

> Pel"n5on+> Pe!e')" se!su"l !ome'si"l "-"u @"ni-" -un" susil"> Pe5"n$u n"'!o-i! > Homose!su"l

3./ eni&< eni& Cen(aki! Menular Sek&ualSe5"'" +"'is ?es"' Pen*"!i- ,enul"' Se!su"l $" "- $i?e$"!"n men)"$i em "-

!elom o!6 "n-"'" l"in:"/ P,S *"n+ menun)u!!"n +e)"l" !linis ?e'u " !elu"'n*" 5"i'"n *"n+ !elu"' $"'i "l"-

!el"min6 *"i-u en*"!i- Gonore dan !retritis /on +pesifik1!/+4 ?/ P,S *"n+ menun)u!!"n "$"n*" lu!" "$" "l"- !el"min mis"ln*" en*"!i-

Chanroid1!lkus mole4" +ifilis" LG. 6 $"n %erpes simpleks)5/ P,S *"n+ menun)u!!"n "$"n*" ?en)ol"n "-"u -umo'6 -e'$" "- "$" en*"!i-

ondiloma akuminata /$/ P,S *"n+ mem?e'i +e)"l" "$" -"h" e'mul""n6 mis"ln*" en*"!i- %epatitis B

7D"ili6 200 8/

3. -e alal"!i +e)"l"n*" ?e'u ":"/ R"s" s"!i- "-"u "n"s s""- !en5in+/

?/ Kelu"'n*" $"'"h s""- !en5in+/5/ Kelu"'n*" n"n"h $"'i enis/

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$/ A$"n*" lu!" "$" "l"- !el"min/e/ R"s" +"-"l "$" enis "-"u $u?u' 7Hu-"+"lun+6 20028/

3. Cen8e"ahan Cen(aki! Menular Sek&ual

A$" un u "*" en5e+"h"n Pen*"!i- ,enul"' Se!su"l *"n+ $" "- $il"!u!"n "$"l"h:"/ Ti$"! mel"!u!"n hu?un+"n se!s/ ?/ ,en)"+" e'il"!u se!su"l 7se e'-i: en++un""n !on$om8/5/ Bil" su$"h ?e' e'il"!u se!s *"n+ "!-i -e-" l"h se-i" "$" "sn+"nn*"/$/ Hin$"'i en++un""n "!"i"n $"l"m se'-" h"n$u! $"'i en$e'i-" P,S/e/ T"@"!"l "$" Tuh"n


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3.10 PENYAKIT MENU A! "EK"UA YAN# $I"E%A%KAN & E' &!#ANI"ME $AN %AKTE!I 3.10.1 HI6HI "$"l"h sin+!"-"n $"'i Hum"n immuno$e i5ien5* i'us/ In e!si "!u- $il" o'!"n $" "-men*e?"?!"n su"-u sin$'om men*e'u "i mononu5leosis $en+"n +e)"l" $em"m6 m"l"ise6n*e'i o-o-6 n*e'i !e "l"6 !elel"h"n6 'u"m +ene'"lis"-"6 s"!i- -en++o'o!"n6 lim "$eno "-i6 $"nlesi mu!o!u-"n *"n+ !h"s/S"l"h s"-u !esuli-"n men+en"li in e!si %uman -mmunideficiency .irus 1%-.4 "$"l"h m"s"l"-en -"n " +e)"l" l"m"6 "n-"'" 2 ?ul"n hin++" -"hun/ Umu' '"-">'"-" s""- $i"+nosisin e!si %uman -mmunideficiency .irus 1%-.4 $i-e+"!!"n "$"l"h 3 -"hun/ 7Benson "n$Pe'noll6 200%8

3.10.2 -onorea=ono'e" me'u "!"n en*"!i- menul"' *"n+ "lin+ se'in+ $i )um "i $i ?e'?"+"i Ne+"'" *"n+le?ih m")u/ Re'"-" $i Ne+"'">ne+"'" ini "$"l"h >10 !"li le?ih -in++i $i?"n$in+!"n $en+"n

Ne+"'" *"n+ !u'"n+ m")u/ 7Lin$"6 200 8Pen*"!i- ini $i-ul"'!"n mel"lui hu?un+"n se!su"l/ Se?u-"n l"in en*"!i- ini "$"l"h !en5in+n"n"h/ Pen*"!i- ini men*e'"n+ o'+"n se!s $"n o'+"n !emih/ Sel"in i-u "!"n men*e'"n+sel" u- len$i' mulu-6 m"-"6 "nus6 $"n ?e?e'" " ?"+i"n o'+"n -u?uh l"inn*"/ B"!-e'i *"n+mem?"@" en*"!i- ini $in"m"!"n +ono5o55us/ Ko!us +'"m ne+"-i e *"n+ men*e?"?!"n

en*"!i- ini *"i-u Neisse'i" =ono''hoe"e/ 7A)en Di"n"@"-i6 20038=e)"l" Klinis =ono'he" *"i-u :

P'i" : $uh -u?uh u'e-'"6 !en-"l6 u-ih !e!unin+"n "-"u !unin+("ni-" : se'in+!"li -"n " +e)"l"6 ?il" "$" $uh -u?uh u-ih "-"u !unin+ -e'u-"m" $i $"e'"hmulu- '"him sehin++" e'lu eme'i!s""n $"l"m/ 7De !es RI6 200 8/ Konse!@ensi!eseh"-"n *"n+ "lin+ en-in+ "!i?"- in e!si +ono''he" "$"l"h !e'us"!"n -u?" "llo i*"n+ ?e'!"i-"n $en+"n 'e$is osisi -e')"$in*" !eh"mil"n e!-o i! 7-u?"8 $"n in e'-ili-"s/7Lin$"6 200 8

3.10.3 "i(ilisSi ilis $i!en"l )u+" $en+"n se?u-"n '")" sin+" / Pen*"!i- ini s"n+"- ?e'?"h"*"/ Pen*"!i- ini$i-ul"'!"n mel"lui hu?un+"n se!su"l "-"u en++un""n ?"'"n+>?"'"n+ $"'i seseo'"n+ *"n+-e'-ul"' 7se e'-i ?")u6 h"n$u!6 $"n )"'um sun-i!8/ Pen*e?"? -im?uln*" en*"!i- ini "$"l"h!um"n -'e onem" "lli$um/ Kum"n ini men*e'"n+ o'+"n>o'+"n en-in+ -u?uh l"inn*" se e'-isel" u- len$i'6 "nus6 ?i?i'6 li$"h $"n mulu-/ 7A)en Di"n"@"-i6 20038=e)"l" umum *"n+ -im?ul "$" si ilis *"i-u "$"n*" lu!" "-"u !o'en+6 )uml"h ?i"s"n*" s"-u6

?ul"- "-"u6 lon)on+6 $"s"' ?e'sih6 -e'"?" !en*"l s"m "i !e'"s6 -i$"! "$" '"s" n*e'i "$" ene!"n"n/ Kelen)"' +e-"h ?enin+ $i li "- "h" ?"+i"n $"l"m mem?es"'6 !en*"l6 )u+" -i$"!n*e'i "$" ene!"n"n/ 7De !es RI6 200 8Un-u! +e)"l" *"n+ le?ih !husus6 A)en Di"n"@"-i 2003 menulis!"n ?"h@" Penul"'"n $"n

+e)"l" *"n+ *"n+ -e'lih"- -e'?"+i $"l"m 3 -in+!"-"n6 $"n se-i" -in+!"-"n ?e'?e$">?e$"/Tin"ka! I

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"/ Penul"'"nn*" su$"h -e'$e-e!si se!i-"' 10>%0 h"'i se-el"h mel"!u!"n hu?un+"nse!su"l/

?/ =e)"l" *"n+ -e'lih"- "$"l"h "$"n*" lu!" !e5il ?e'n"n"h $ise'-"i '"s" s"!i- *"n+ "m"-s"n+"-6 sel"n)u-n*" -e')"$i em?en+!"!"n !elen)"' +e-"h ?enin+ *"n+ men+e'"s

$ise!i-"' lu!"6 se e'-i $ili "-"n "h"/Tin"ka! II"/ Te')"$i se!i-"' 40 h"'i se-el"h m"su! "$" -in+!"- 1/

?/ =e)"l" *"n+ -e'lih"- "$"l"h "$"n*" lu!">lu!" !e5il ?e'@"'n" me'"h $i se!i-"' e'mu!""n !uli-6 $"'i !uli- !e "l" hin++" -el" "! -"n+"n $"n !"!i/ Lu!">lu!" ini-im?ul !"'en" !um"n -el"h men*e?"' mel"lui e'e$"'"n $"'"h/

5/ =e)"l" l"inn*" "$"l"h !eluh"n s"!i- -en++o'o!"n6 unsin+6 lesu6 n*e'i o-o-6 -e')"$i!e'on-o!"n '"m?u-6 $"n !uli- !e "l" -e'"s" +"-"l/

Tin"ka! III"/ Te')"$i se-el"h 10>1 -"hun !emu$i"n/

?/ =e)"l"n*" "n-"'" l"in $i-emu!"n ?en)ol"n>?en)ol"n "$" ?"+i"n -u?uh *"n+ -e'se'"n+/P"$" "nhi'n*" ?e'n)ol"n -e'se?u- melun"! $"n e5"h sehin++" men+elu"'!"n 5"i'"n/B"+i"n -u?uh *"n+ -e'se'"n+ "!"n men+"l"mi !e'us"!"n/ ;i!" !um"n mul"imen*e'"n+ o-"!6 o'"n+ *"n+ -e'se'"n+ "!"n men+"l"mi +"n++u"n !e)i@""n "-"u +il"/;i!" *"n+ $ise'"n+ ?"+i"n sumsum -ul"n+ ?el"!"n+6 nis5"*" o'"n+ -e'se?u- "!"nmen+"l"mi !elum uh"n6 !emun$u'"n !e')" )"n-un+6 $"n !e'us"!"n )"'in+"n susun"ns"'" 6 se'-" m"sih ?"n*"! l"+i !e'us"!"n>!e'us"!"n l"inn*"/ Be+i-u se-e'usn*"6 !"'en"!um"n>!um"n -"$i $" "- men*e'"n+ ?"+i"n -u?uh m"n" un -"n " mem"n$"n+ si" "o'"n+n*"/ Resi!o "lin+ "-"l en*"!i- ini $" "- men+"!i?"-!"n !em"-i"n/

5/ Pe'em u"n *"n+ h"mil ?is" s")" -e'se'"n+ en*"!i- ini6 sehin++" ?"*i *"n+ "!"n l"hi'men+"l"mi !elum uh"n isi! $"n men-"l6 i-u un )i!" me'e!" $" "- ?e'-"h"n hi$u /Bi"s"n*"6 ?"*i>?"*i ini "!"n menin++"l $"l"m !"n$un+"n )i!" !um"n men*e'"n+u-e'us/ K"l"u un ?is" l"hi'6 ?"*i>?"*i ini menin++"l semin++u se-el"h !el"hi'"nn*"/S"*"n+n*"6 o?"- un-u! men*el"m"-!"n "'" ?"*i *"n+ -e'se'"n+ en*"!i- ini s"m "ise!"'"n+ ?elum "$"/

3.10.4 )aginitis"+ini-is "$"l"h is-il"h *"n+ $i "!"i un-u! menun)u!!"n "$"n*" in e!si "-"u e'"$"n+"n"+in"/ "+ini-is ?i"s"n*" $i-"n$"i $en+"n "$"n*" 5"i'"n ?e'?"u !u'"n+ en"! *"n+ !elu"'

$"'i "+in"/ =e)"l" l"in "$"l"h +"-"l "-"u i'i-"si $i $"e'"h !em"lu"n $"n e'ih se@"!-u!en5in+/ Be?e'" " !"sus "+ini-is $ise?"?!"n oleh 'e"!si "le'+i "-"u !e e!""n -e'h"$"

?"h"n !imi"/ Umumn*" $ise?"?!"n oleh !um"n *"n+ $i-ul"'!"n se5"'" se!su"l "-"u *"n+-"$in*" mene-" $i "+in" $"n men)"$i +"n"s !"'en" +"n++u"n !eseim?"n+"n $i $"l"m

"+in" 7Hu-" e"6 20038/

3.10./ KlamidiaKl"mi$i" ?e'"s"l $"'i !"-" Chlamydia 6 se)enis o'+"nisme mi!'os!o i! *"n+ $" "-men*e?"?!"n in e!si "$" lehe' '"him6 s"lu'"n in$un+ -elu'6 $"n $"n s"lu'"n !en5in+/ =e)"l"

*"n+ ?"n*"! $i)um "i "$" en$e'i-" en*"!i- ini "$"l"h !elu"'n*" 5"i'"n $"'i "+in" *"n+ ?e'@"'n" !unin+6 $ise'-"i '"s" "n"s se e'-i -e'?"!"' !e-i!" !en5in+/ K"'en" o'+"nisme ini

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$" "- mene-" sel"m" ?e'-"hun>-"hun $"l"m -u?uh seseo'"n+/ I" )u+" "!"n me'us"! o'+"n'e 'o$u!si en$e'i-" $en+"n "-"u -"n " me'"s"!"n +e)"l" " " un/ 7A)en Di"n"@"-i6 20038

3.10. *andidiasis

,e'u "!"n in e!si "$" mu"'" $"n s"lu'"n "+in" *"n+ "lin+ se'in+ -e')"$i oleh !"'en"se)enis '"+i/ P"$" !en*"-""nn*" !um"n Candida 5lbicans ini hi$u "$" sel" u- len$i' $"'ise?"+i"n ?es"' o'"n+ *"n+ seh"- $"n -en-un*" me'u "!"n !um"n *"n+ umum $i-emu!"n$"l"m "+in"/ Se?u-"n n"m" 5"n$i$" se?"+"i en*"!i- menul"' se!su"l m"sih ?"'u6 n"mun$emi!i"n sem"!in ?e'-"m?"h ?u!-i "$"n*" enul"'"n mel"lui hu?un+"n se!s/ 7Ros"'i6 200.8Pen*"!i- ini ?i"s" )u+" $ise?u- se?"+"i in e!si '"+i/ Se?en"'n*"6 $"l"m "+in" -e'$" "-

?e')u-">)u-" '"+i/ ,es!i un -i$"! "!"n menim?ul!"n m"s"l"h6 !"'en" '"+i ?e'!em?"n+ -e'l"lu es"-6 $"l"m !e"$""n -e'-en-u $" "- men*e?"?!"n in e!si/ =e)"l" *"n+ $" "- -e'lih"- "$" e'em u"n "$"l"h !elu"'n*" 5"i'"n !en-"l ?e'@"'n" u-ih $ise'-"i $en+"n em?en+!"!"n $"n+"-"l>+"-"l "$" "+in"/ P"$" l"!i>l"!i6 in e!si ini $" "- men*e?"?!"n '"s" "n"s6 se e'-i-e'?"!"' $"n +"-"l "$" s"lu'"n !en5in+n*"/ 7A)en Di"n"@"-i6 20038

3.10. *han+r,id Pen*"!i- ini $i"@"li $en+"n ?en)ol"n>?en)ol"n !e5il *"n+ mun5ul $ise!i-"' +ene-"li" "-"u"nus6 4> h"'i se-el"h !on-"! $en+"n en$e'i-"/ Ben)ol"n i-u "!hi'n*" "!"n -e'?u!" $"nmen+elu"'!"n 5"i'"n *"n+ ?e'?"u -i$"! se$" / Bo'o! 5h"n5'oi$ "$" 'i" ?i"s"n*" s"n+"-men*"!i-!"n6 se$"n+!"n "$" @"ni-" -i$"! menim?ul!"n '"s" s"!i- 7Ros"'i6 200.8&h"n5'oi$ "$"l"h se)enis ?"!-e'i *"n+ men*e'"n+ !uli- !el"min $"n men*e?"?!"n lu!" !e5il

?e'n"n"h/ ;i!" lu!" ini e5"h6 ?"!-e'i "!"n men)"l"' !e"'"h u?i! $"n !el"min/ 7A)en

Di"n"@"-i6 20038

3.10. #ran-la ing-inalePen*"!i- ini s"m" $en+"n 5h"n5'oi$6 *"i-u $ise?"?!"n oleh ?"!-e'i/ B"+i"n *"n+ -e'se'"n+

?i"s"n*" e'mu!""n !uli- enis6 ?i?i' "+in"6 !li-o'is6 $"n "nus6 "!"n ?e'u?"h mem?en-u! )"'in+"n ?e'isi 5"i'"n *"n+ men+elu"'!"n ?"u -i$"! se$" sel"n)u-n*" "!"n -e')"$i em?es"'"n *"n+ ?e'si "- e'm"nen "-"u -e'lih"- sese!"li "$" enis6 !li-o'is6 $"n !"n$un+ eli'/ Pen$e'i-" ?is" !ehil"n+"n ?e'"- ?"$"n6 !emu$i"n menin++"l $uni"/ Pen*"!i- ini -i$"!mem e'lih"-!"n +e)"l">+e)"l" "@"l6 ,em"su!i m"s" 3 ?ul"n6 ?"'ul"h -e'lih"- "$"n*" in e!si*"n+ s"n+"- ?e'?"h"*" $"n $" "- $i-ul"'!"n !e "$" o'"n+ l"in/ 7A)en Di"n"@"-i6 20038

3.11 PENYAKIT MENU A! "EK"UA YAN# $I"E%A%KAN & E' )I!U" 3.11.1 'er esHe' es -e'm"su! )enis en*"!i- ?i"s"6 $ise?"?!"n oleh i'us he' es sim le!s/ i'us he' es-e'?"+i 2 m"5"m6 *"i-u he' es 1 $"n he' es 2/ Pe'?e$""n $i"n-"'"n*" "$"l"h !e?"+i"n m"n"

i'us -e'se?u- men*e'"n+/ He' es 1 men*e'"n+ $"n men+in e!si ?"+i"n mulu- $"n ?i?i'6se$"n+!"' he' es 2 "-"u $ise?u- +eni-"l he' es men*e'"n+ $"n men+in e!si ?"+i"n se!su"l7 enis "-"u "+in"8/ 7A)en Di"n"@"-i6 20038Pe'?e$""n HS -i e I $en+"n -i e II

HS6 !i e I HS6 !i e II

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P'e$ile!siKuli- $"n mu!os" $i lu"' Kuli- $"n mu!os"

$"e'"h +ene-"li" $"n e'i"n"l

Kul-u' "$" 5ho'io"ll"-oi5mem?'"n 7&A,8 $"'i -elu'

"*"m

,em?en-u! ?e'5"! !e5il ,em?en-u! o5! ?es"' $"n -e?"l

Se'olo+i An-i?o$i -e'h"$" HS -i e I

An-i?o$i -e'h"$" HS -i e II

Si "- l"in Ti$"! ?e'si "- on!o+eni Be'si "- on!o+eni

=e)"l" !linis he' es ini *"i-u :1/ He' es =eni-"l Pe'-"m"/ Di"@"li $en+"n ?in-il Q len-in+"n Q lu!" C e'osi

?e'!elom o!6 $i "-"s $"s"' !eme'"h"n6 s"n+"- n*e'i6 em?es"'"n !elen)"' li "- "h"6!en*"l6 $"n $ise'-"i +e)"l" sis-emi!

2/ He' es =eni-"l K"m?uh"n/Tim?ul ?il" "$" "5-o' en5e-us 7$"*" -"h"n menu'un6"!-o' s-'ess i!i'"n6 sen++"m" ?e'le?ih"n6 !elel"h"n $"n l"in>l"in8/ Umumn*" lesi

-i$"! se?"n*"! $"n se?e'"- "$" lesi 'ime'/ 7De !es6 200 8i'us he' es ini -i$"! $" "- $isem?uh!"n6 -e-" i $" "- $io?"-i/ O?"- *"n+ ?i"s" $i?e'i!"n

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3.11.2 )iral 'e atitis

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3.11.3 ym h,gran-l,ma /enere-mPen*"!i- ini ?i"s" $isin+!"- L= 6 $ise?"?!"n oleh i'us $"n $" "- mem en+"'uhi selu'uho'+"n -u?uh/ Pen*"!i- ini s"n+"- ?e'?"h"*" !"'en" "n-i?io-i5 -i$"! $" "- men"n++ul"n+in*"/=e)"l" "@"ln*" ?e'u " lu!" !e5il *"n+ -i$"! ?i"s" -e')"$i $i se!i-"' o'+"n se!su"l sel"m" 3min++u/ Du" min++u !emu$i"n6 lu!" -e'se?u- mem?en+!"! se?es"' -elu' *"n+ men*e?"' $i

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3.1 PENYAKIT MENU A! "EK"UA YAN# $I"E%A%KAN & E' PA!A"IT 3.12.1 Tri+h,m,niasisTrichomoniasis "-"u trich "$"l"h su"-u in e!si "+in" *"n+ $ise?"?!"n oleh su"-u "'"si- "-"usu"-u 'o-o o" 7he@"n ?e'sel -un++"l8 *"n+ $ise?u- trichomonas 'aginalis / =e)"l"n*"meli u-i e'"s""n +"-"l $"n -e'?"!"' $i $"e'"h !em"lu"n6 $ise'-"i $en+"n !elu"'n*" 5"i'"n

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3.12.2 Pedi+-l,sis Pediculosis "$"l"h -e'$" "-n*" !u-u "$" ?ulu>?ulu $i $"e'"h !em"lu"n/ Ku-u u?is ini $i?e'i )ulu!"n crabs !"'en" ?en-u!n*" *"n+ mi'i !e i-in+ se e'-i $i ?"@"h mi!'os!o / P"'"si- ini

)u+" $" "- $ilih"- $en+"n m"-" -el"n)"n+/ P"'"si- ini menem el "$" '"m?u- $"n $" "- hi$u$en+"n 5"'" men+is" $"'"h6 sehin++" menim?ul!"n +"-"l>+"-"l/ ,"s" hi$u n*" sin+!"-6h"n*" se!i-"' s"-u ?ul"n/ Te-" i !u-u ini $" "- -um?uh su?u' $"n ?e'-elu' ?e'!"li>!"lise?elum m"-i 7Hu-" e"6 20038/

DAFTAR C STAKA

A??"ssi>=h"n" "-i ,6 ='ee' L=6 &unnin+h"m 9=/ Pregnancy and laboratory studies: a referencetable for clinicians) 6bstet Gynecol / 200% De5 1147.8:132.>31/

A$'i""ns =/200 / 5suhan 5ntenatal / ;"'in+"n N"sion"l Pel"-ih"n Klini!: Keseh"-"n Re 'o$u!si/An@"' ,6 B" i"$ A6 P'"?o@o RP/ 2011/ -lmu andungan 0d) 7 Cet)2 / ;"!"'-": PT Bin" Pus-"!"

S"'@ono P'"@i'oh"'$)o/

A h"'i/ 2002/ Masalah 5bortus dan esehatan (eproduksi Perempuan / P"lem?"n+: 9K UnS'i/

&unnin+h"m 9=6 ="n- N96 Le eno K;/ In: 8illiam9s 6bstetrics / E$ 21/ The ,5 ='"@>Hill&om "nies/ Ne@


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laporan skenario d (abortus insipiens)

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