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    Siasatan Kes Ibu Hamil Hiv Positif

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    Pooneethawathi Santran
    This document summarizes the case of a 30-year-old HIV-positive pregnant woman from India. It details her antenatal care, HIV treatment and viral load monitoring during pregnancy. Her husband was also found to be HIV positive. The woman delivered via emergency c-section and her baby tested negative for HIV on the first PCR test. Areas for improvement in her care included ensuring the baby completes all HIV testing and the mother remains adherent to antiretroviral treatment and family planning methods.

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    Siasatan Kes Ibu Hamil Hiv Positif

    Uploaded by

    Pooneethawathi Santran
    52 views12 pages
    This document summarizes the case of a 30-year-old HIV-positive pregnant woman from India. It details her antenatal care, HIV treatment and viral load monitoring during pregnancy. Her husband was also found to be HIV positive. The woman delivered via emergency c-section and her baby tested negative for HIV on the first PCR test. Areas for improvement in her care included ensuring the baby completes all HIV testing and the mother remains adherent to antiretroviral treatment and family planning methods.

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    SIASATAN KES IBU HAMIL HIV POSITIF (1)

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    This document summarizes the case of a 30-year-old HIV-positive pregnant woman from India. It details her antenatal care, HIV treatment and viral load monitoring during pregnancy. Her husband was also found to be HIV positive. The woman delivered via emergency c-section and her baby tested negative for HIV on the first PCR test. Areas for improvement in her care included ensuring the baby completes all HIV testing and the mother remains adherent to antiretroviral treatment and family planning methods.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    52 views12 pages

    Siasatan Kes Ibu Hamil Hiv Positif

    Uploaded by

    Pooneethawathi Santran
    This document summarizes the case of a 30-year-old HIV-positive pregnant woman from India. It details her antenatal care, HIV treatment and viral load monitoring during pregnancy. Her husband was also found to be HIV positive. The woman delivered via emergency c-section and her baby tested negative for HIV on the first PCR test. Areas for improvement in her care included ensuring the baby completes all HIV testing and the mother remains adherent to antiretroviral treatment and family planning methods.

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    SIASATAN KES IBU HAMIL HIV POSITIF

    NEGERI KEDAH DARUL AMAN


    2017

    KLINIK KESIHATAN LUNAS


    A. BIODATA
    IBU HAMIL SUAMI / PASANGAN
    Nama Komathi a/p Mohan Ragavan a/l Muniandy
    Umur 30 37
    Bangsa / Warganegara (jk WNA) India India
    Gravida / pariti G2P1
    LNMP / (R) EDD 24/2/2017
    1/12/2017
    Pekerjaan Factory operator Lorry driver
    Tarikh saringan HIV November 2016 15/5/2017: HIV rapid test
    1/12/2016;(BLOOD BAG) 17/5/2017
    ELISA/PA: REACTIVE HIV PA detected
    9/5/2017
    HIV Ag-Ab: reactive
    9/5/2017
    HIV PA DETECTED
    15/5/17:rapid test reactive

    Tarikh pengesahan HIV 9/5/2017 29/5/17


    Faktor risiko jangkitan HIV Unknown High risk behaviours:
    2 marriage
    nd
    History of sexual promiscuity more than 10
    years ago
    Substance abuser: heroine chaser, ice
    tatooing

    Tarikh Notifikasi 30/5/2017 30/5/2017


    **Status HIV ( Nyatakan) Baru Baru
    B. SEJARAH KEHAMILAN IBU (CURRENT PREGNANCY )
    TARIKH POA Catatan
    Booking 15/5/17 11/52
    +4/7
    Rawatan ARV ( & nama ubat) 5/6/17 14/52 + T. Combivir 1/1 BD
    15/10/17 37/52 T.Efavirenz 600mg ON
    Off T.combivir change to T.Tenvir-Em

    CD4 COUNT 8/5/17 10/52+ 470c/ul


    15/10/17 37/52+ 817c/ul
    VIRAL LOAD 30/5/17 13/52+ 1064cp/mL
    17/10/17 37/52+ <20cp/mL (Pre-delivery)
    Pelan Jagaan Ibu Antenatal
     Rujukan kepada FMS 8/5/17 10/52+
    At Klinik 11/52+
    Kesihatan
    Seberang
    Jaya
    12/5/18
    Klinik
    Kesihatan
    Lunas

     F/Up Di Klinik Antenatal 7 visits to FMS


    13 visits to MCHC
    2 home visits
     Rujukkan Ke ID  None

     Compliance Terhadap Compliance fair


    Rawatan & F/UP On and off defaulted blood taking TCA
    Due to difficult to get leave

     Kaunseling sex Compliance


    selamat , pemberian Condom supplied
    condom

     Masalah yang 1)Anaemia secondary to ? Combivir and


    dikenalpasti & iron deficiency anaemia
    pengendalian Medication changed from T.Combivir
    1/1BD to T.TenvirEm 1/1 OD
    C. PENGENDALIAN SUAMI / PASANGAN

    TARIKH MASALAH PENGENDALIAN MASALAH & CATATAN


    YANG
    DIKENALPASTI

    29/5/17 RVD POSITIF 5/6/17: Started HAART- T.Combivir1/1 OD


    T.Efavirenz 600mg OD

    29/8/17 Started Isoniazid prophylaxis therapy


    UJIAN-UJIAN LAIN
    UJIAN IBU HAMIL SUAMI / PASANGAN CATATAN
    HEPATITIS B 9/5/17&13/7/17 15/6/17
    HbsAg: Non-reactive HbsAg: non reactive
    HEPATITIS C 9/5/17&13/7/17 15/6/17
    Anti –HCV: Non- Anti –HCV: Non-
    reactive reactive
    HIV HIV reactive 15/5/15:HIV rapid
    9/5/17 test:positive
    HIV Ag-Ab : Reactive 17/5/17:
    HIV PA: particle HIV PA; particle
    Agglutination Assay Agglutination Assay
    HIV -1: detected HIV -1: detected

    HVS C&S 31/8/17:no growth -


    GC SMEAR 29/8/17: negative -
    VDRL / TPHA 9/5/17: non reactive -
    15/5/17:non reactive
    TOXO IgG NA -
    SPUTUM AFB None -
    CXR Clear
    OGTT 16/5/17 FBS: 4.7
    4.7/5.19(mmol/L)
    26/9/17
    4.56/6.78(mmol/L)
    Hb Refer table 14.9g/dL
    LFT
    11/10/17 13/7/17
    ALP:239umol/L ALP: 200.3umol/L
    ALT: 9.7U/L ALT: 26.1U/L
    AST: 11.2U/L AST: 20.2U/L
    17/7/17 6/6/17
    ALP:119.7umol/L ALP: 182umol/L
    ALT: 12.8U/L ALT: 28.9U/L
    AST: 17.4U/L AST: 27.1U/L
    7/11/17 23/1/18
    ALP:269umol/L ALP: 195umol/L
    ALT: 6.5U/L ALT: 26U/L
    AST: 13.2U/L AST: 27U/L
    23/1/2018
    ALP: 237
    AST: 13
    ALT:17

    RENAL FUNCTION
    11/10/17 6/6/17
    Urea: 4.8mmol/L Urea: 3.15mmol/L
    Creat: 75umol/L Creat: 100umol/L
    K: 3.5mmol/L K: 5mmol/L
    Na : 142.5mmol/L Na : 137.8mmol/L
    7/11/17
    Urea: 2.25mmol/L
    Creat: 75umol/L
    K: 3.6mmol/L
    Na : 133.4mmol/L
    23/1/2018
    Urea: 2.62mmol/L
    Creat: 92umol/L
    K: 4.03mmol/L
    Na : 139.4mmol/L
    Date/POG 8/5/17 13/6/17@ 11/7/18 1/8/17 15/8/17 29/8/17 26/9/17 10/20/17
    @10/52+ @15/52+ @19/52+ @22/52+ @ @ @ @32/52
    24/52 26/52+1/7 30/52
    +4/7

    Haemoglobin 12.1 10.7 10.4 9.2 9.8 10 10.4 9.2


    (g/dL)

    T.Zincofer 1/1 T.Iberat I/I OD UTI T.Maltofer 1/1 T.Maltofer


    Od OD 1/1BD

    24/10/17 7/11/17 Postpartum


    34/52+4/7 36/52 1/1/18
    9.6 10.4 12.7
    IM cosmofer

    Serum 12/7/17 17/8/17


    Ferritin 12pmol/L 11pmol/L(L)
    5ng/mL(N) 5ng/Ml

    Full Blood 26/9/17


    picture Mild hypochromic
    microcytic anaemia
    suggestive of Iron
    Deficiency Anaemia
    KELAHIRAN / MAKLUMAT PENGENDALIAN BAYI

    NAMA BAYI DUSHANTH


    No MyKid /JANTINA / BERAT 171128021027/MALE/3.38KG
    LAHIR
    MODE OF DELIVERY EMERGENCY LOWER SEGMENET
    CAESAREAN SECTION for poor
    progress
    TEMPAT KELAHIRAN HOSPITAL KULIM
    INTRAPARTUM AZT Given
    Pelan Jagaan SCN
    ARV (Rawatan) ketika discaj Syr Zidovudine 14mg BDx 6/52
    Feeding replacement Formula feeding
    Status HIV NON-REACTIVE
    PCR 1 (Tarikh & keputusan) 29/11/17 –HIV 1 RNA NOT
    DETECTED
    PCR 2 (Tarikh & keputusan) 7/1/18 – wrong sample
    25/3/18-wrong bottle
    26/4/18(repeat)

    PCR 3 (Tarikh & keputusan) -

    Pemberian imunisasi Up to age

    Pemberian Profilaksis Bactrim -


    G. Jagaan ibu lepas bersalin

    Rujukan ke PPHIV / ID linic KKLUNAS


    Status rawatan ARV Cont HAART
    Perancang Keluarga IM depo/condom( advice for
    Implanon: refused)
    Isoniazid Profilaksis (IPT) Not yet
    Kontraseptif IM depo/condom
    Sokongan Sosial Husband and family
    Pengendalian kontak ( anak- -1st child(1st marriage- 2013 not
    anak, dll) screened for HIV
     Rujukan kepada Dr
     ujian HIV & keputusan
     imunisasi
    KELEMAHAN DALAM PENGENDALIAN

    KELEMAHAN DIKENALPASTI TINDAKAN PENAMBAHBAIKAN YANG DIAMBIL

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