Wanita Multigravida Usia Kehamilan 37 Minggu dengan Penyakit Penyerta HIV dan Kanker Serviks
DOI:
https://doi.org/10.32734/scripta.v1i`1.1212Keywords:
HIV, Kanker Serviks, Ca serviks, Servical Cancer, Pregnancy, KehamilanAbstract
ABSTRAK
Human Immunodeficiency Virus (HIV) adalah virus yang menyerang sel darah putih di dalam tubuh (limfosit) yang mengakibatkan turunnya kekebalan tubuh manusia. Kanker serviks adalah kanker yang muncul pada sel-sel dileher rahim. Seorang ibu usia 32 tahun datang dengan keluhan perut keram dengan nyeri menjalar ke pinggang, sering keluar darah dari kemaluan sejak usia kehamilan 5 bulan. Pada awalnya pasien mengalami keputihan dengan berbau amis yang sering setiap harinya. Pasien memilki riwayat penyakit penyerta berupa HIV dan kanker serviks. Ini adalah kehamilan ketiga bagi pasien. Pada pemeriksaan obstetri, tinggi fundus uteri adalah 32 cm, uterus tidak ada kontraksi, denyut jantung janin 140 x/menit dan 128 x/menit serta pada inspekulo didapatkan portio tidak rata atau bernodul-nodul, Ostium Uteri Eksterna (OUE) tertutup, fluor -, fluksus + dengan darah tak aktif. Erosi, polip, dan laserasi juga tidak ada dijumpai. Diagnosa pasien adalah multigravida hamil 37 minggu belum inpartu dengan HIV dan kanker serviks stadium IA janin tunggal hidup presentasi kepala. Penatalaksanaan pada pasien dengan observasi tanda vital ibu, kontraksi uterus, dan denyut jantung janin, cek darah lengkap, diinfus dengan cairan ringer laktat 20tetes/menit, Transfusi PRC 2 kantong (250mL) dan rencana terminasi per-abdominam. HIV mengawali adanya lesi prakanker hingga adanya kanker yang disebabkan adanya penurunan imun pada HIV sehingga memudahkan HPV menyerang pasien dengan HIV. Terapi surgikal lebih dianjurkan dibandingkan dengan terapi ablatif pada penanganan lesi prakanker serviks dengan infeksi HIV.
Kata Kunci: Ca Serviks, HIV, Kehamilan
ABSTRACT
Human Immunodeficiency Virus (HIV) is a virus who attacks white blood cells in the body (lymphocytes) which results in a decrease of immunity in human body. Cervical cancer is a cancer that appears in cells of the uterus neck. A 32-year-old mother presents with complaints of stomach cramps with pain radiating to the waist, often bleeding from the genitals from 5 months of pregnancy. At first the patient experiences vaginal discharge with frequent fishy odor every day. This patient has the history of HIV and cervical cancer. This is the third preganancy of the patient. On obstetric examination, the uterine fundus height is 32 cm, the uterus has no contractions, the fetal heart rate is 140 x / minute and 128 x / minute and inspeculo has a knurl, closed External Ostium of Uterus (EOU), fluorine, fluxus. + with blood inactive and there is no polyps, erotion, or laceration to be found. Patients diagnosed with 37 weeks of pregnancy in unborn with HIV and stage IA cervical cancer single fetus live head presentation. Management of the patient with observation of the mother's vital signs, uterus contraction, fetal heart rate, laboratory check complete blood, infused with ringer lactate 20drop/minute, 2 bag PRC (250Ml) transfusion and plans for abdominal elimination (per-abdominam). HIV initiates precancerous lesions until cancer is caused by an immune decline in HIV that makes it easier for HPV to attack patients with HIV. Surgical therapy is more recommended than ablative therapy in the treatment of cervical precancerous lesions with HIV infection.
Keywords: Cervical Ca, HIV, Pregnancy
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