{"id":18697,"date":"2023-04-12T17:55:29","date_gmt":"2023-04-12T10:55:29","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=18697"},"modified":"2023-04-24T22:26:48","modified_gmt":"2023-04-24T15:26:48","slug":"chan-doan-va-phac-do-dieu-tri-thai-ngoai-tu-cung","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/12\/chan-doan-va-phac-do-dieu-tri-thai-ngoai-tu-cung\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n v\u00e0 ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb thai ngo\u00e0i t\u1eed cung"},"content":{"rendered":"<p><strong>Thai ngo\u00e0i t\u1eed cung l\u00e0 t\u00ecnh tr\u1ea1ng ph\u00f4i ph\u00e1t tri\u1ec3n \u1edf ngo\u00e0i t\u1eed cung, th\u01b0\u1eddng l\u00e0 trong \u1ed1ng d\u1eabn, tr\u00ean bu\u1ed3ng tr\u1ee9ng ho\u1eb7c ngo\u00e0i n\u1ed9i m\u1ea1c t\u1eed cung. \u0110\u00e2y l\u00e0 m\u1ed9t trong nh\u1eefng bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m nh\u1ea5t c\u1ee7a thai k\u1ef3 v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng \u0111e d\u1ecda \u0111\u1ebfn t\u00ednh m\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n.<\/strong><\/p>\n<h2><strong>1. Y\u1ebfu t\u1ed1 nguy c\u01a1 v\u00e0 ph\u00e2n lo\u1ea1i\u00a0<\/strong><\/h2>\n<p><strong>1.1 Y\u1ebfu t\u1ed1 nguy c\u01a1<\/strong><\/p>\n<ul>\n<li>Vi\u00eam nhi\u1ec5m sinh d\u1ee5c, \u0111\u1eb7c bi\u1ec7t do Chlamydia trachomatis<\/li>\n<li>Ti\u1ec1n s\u1eed ph\u1eabu thu\u1eadt \u1ed1ng d\u1eabn tr\u1ee9ng: t\u00e1i t\u1ea1o \u1ed1ng d\u1eabn tr\u1ee9ng, n\u1ed1i \u1ed1ng d\u1eabn tr\u1ee9ng sau tri\u1ec7t s\u1ea3n<\/li>\n<li>Ti\u1ec1n s\u1eed thai ngo\u00e0i t\u1eed cung<\/li>\n<li>H\u1ed7 tr\u1ee3 sinh s\u1ea3n: k\u00edch th\u00edch r\u1ee5ng tr\u1ee9ng, th\u1ee5 tinh trong \u1ed1ng nghi\u1ec7m v\u00e0 chuy\u1ec3n ph\u00f4i<\/li>\n<li>B\u1ea5t th\u01b0\u1eddng gi\u1ea3i ph\u1eabu \u1ed1ng d\u1eabn tr\u1ee9ng: polyp, t\u00fai th\u1eeba,..<\/li>\n<li>\u0110\u1eb7t d\u1ee5ng c\u1ee5 t\u1eed cung \u00edt c\u00f3 nguy c\u01a1 thai ngo\u00e0i t\u1eed cung h\u01a1n nh\u1eefng\u00a0 ng\u01b0\u1eddi kh\u00f4ng \u00e1p d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai n\u00e0o<\/li>\n<li>N\u1ed9i ti\u1ebft tr\u00e1nh thai \u0111\u01b0\u1eddng u\u1ed1ng, tr\u00e1nh thai kh\u1ea9n c\u1ea5p th\u1ea5t b\u1ea1i, ti\u1ec1n c\u0103n ph\u00e1 thai, s\u1ea9y thai hay m\u1ed5 l\u1ea5y thai kh\u00f4ng l\u00e0m t\u0103ng nguy c\u01a1 thai ngo\u00e0i t\u1eed cung<\/li>\n<\/ul>\n<figure id=\"attachment_19281\" aria-describedby=\"caption-attachment-19281\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-19281\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-13-300x300.png\" alt=\"Thai ngo\u00e0i t\u1eed cung\" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-13-300x300.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-13-1024x1024.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-13-150x150.png 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-13-768x768.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-13.png 1080w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-19281\" class=\"wp-caption-text\">Thai ngo\u00e0i t\u1eed cung<\/figcaption><\/figure>\n<p><strong>2. Ph\u00e2n lo\u1ea1i<\/strong><\/p>\n<ul>\n<li>Chi\u1ebfm 1\/80 thai k\u1ef3 t\u1ef1 nhi\u00ean\n<ul id=\"attachment_28104\" class=\"wp-caption alignnone\" style=\"width: 300px;\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-28104\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-24-luc-21.48.19-300x179.png\" alt=\"C\u00e1c v\u1ecb tr\u00ed TNTC\" width=\"300\" height=\"179\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-24-luc-21.48.19-300x179.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Anh-chup-Man-hinh-2023-04-24-luc-21.48.19.png 768w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/>C\u00e1c v\u1ecb tr\u00ed TNTC<\/ul>\n<\/li>\n<\/ul>\n<h2>2. C\u00e1c tri\u1ec7u ch\u1ee9ng gi\u00fap ch\u1ea9n \u0111o\u00e1n thai ngo\u00e0i t\u1eed cung<\/h2>\n<p><strong>2.1 Thai ngo\u00e0i t\u1eed cung t\u1ea1i \u1ed1ng d\u1eabn tr\u1ee9ng ch\u01b0a v\u1ee1<\/strong><\/p>\n<ul>\n<li>Tam ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh g\u1ed3m tr\u1ec5 kinh, rong huy\u1ebft, \u0111au b\u1ee5ng<\/li>\n<li>Kh\u00f4ng thay \u0111\u1ed5i sinh hi\u1ec7u<\/li>\n<li>B\u1ee5ng kh\u00f4ng c\u0103ng hay c\u0103ng nh\u1eb9, c\u00f3 th\u1ec3 c\u00f3 ph\u1ea3n \u1ee9ng ph\u00fac m\u1ea1c<\/li>\n<li>\u00c2m \u0111\u1ea1o ra huy\u1ebft ho\u1eb7c kh\u00f4ng<\/li>\n<li>T\u1eed cung h\u01a1i to m\u1ec1m<\/li>\n<li>C\u1ed5 t\u1eed cung t\u00edm, m\u1ec1m<\/li>\n<li>C\u00f3 th\u1ec3 s\u1edd \u0111\u01b0\u1ee3c kh\u1ed1i c\u1ea1nh t\u1eed cung, \u0111au n\u1ec1<\/li>\n<\/ul>\n<p><strong>2.2 Thai ngo\u00e0i t\u1eed cung t\u1ea1i \u1ed1ng d\u1eabn tr\u1ee9ng \u0111\u00e3 v\u1ee1<\/strong><\/p>\n<ul>\n<li>Tr\u1ec5 kinh, rong huy\u1ebft, \u0111au h\u1ea1 v\u1ecb, c\u00f3 th\u1ec3 c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng k\u00edch th\u00edch ph\u00fac m\u1ea1c<\/li>\n<li>Thay \u0111\u1ed5i sinh hi\u1ec7u<\/li>\n<li>Ch\u1ec9 s\u1ed1 s\u1ed1c t\u0103ng<\/li>\n<li>B\u1ee5ng c\u0103ng \u0111au, c\u00f3 ph\u1ea3n \u1ee9ng th\u00e0nh b\u1ee5ng<\/li>\n<li>Kh\u00e1m \u0111\u00e2m \u0111\u1ea1o: t\u1eed cung v\u00e0 ph\u1ea7n ph\u1ee5 kh\u00f3 x\u00e1c \u0111\u1ecbnh do \u0111au. C\u00f9ng \u0111\u1ed3 sau c\u0103ng \u0111au<\/li>\n<li>Ch\u1ecdc d\u00f2 c\u00f9ng \u0111\u1ed3: C\u00f3 m\u00e1u s\u1eadm kh\u00f4ng \u0111\u00f4ng. C\u00e2n nh\u1eafc t\u00ednh c\u1ea7n thi\u1ebft c\u1ee7a vi\u1ec7c th\u1ef1c hi\u1ec7n ch\u1ecdc d\u00f2 c\u00f9ng \u0111\u1ed3 sau<\/li>\n<\/ul>\n<p><strong>2.3 Huy\u1ebft t\u1ee5 th\u00e0nh nang<\/strong><\/p>\n<ul>\n<li>Tr\u1ec5 kinh, rong huy\u1ebft, \u0111au v\u00f9ng ch\u1eadu k\u00e9o d\u00e0i<\/li>\n<li>C\u00f3 th\u1ec3 c\u00f3 tri\u1ec7u ch\u1ee9ng k\u00edch th\u00edc b\u00e0ng quang, tr\u1ef1c tr\u00e0ng<\/li>\n<li>Thi\u1ebfu m\u00e1u<\/li>\n<li>Kh\u00e1m \u00e2m \u0111\u1ea1o: kh\u1ed1i c\u1ea1nh t\u1eed cung c\u00f3 gi\u1edbi h\u1ea1n kh\u00f4ng r\u00f5, c\u0103ng \u0111au<\/li>\n<\/ul>\n<p><strong>2.4 Thai trong \u1ed5 b\u1ee5ng<\/strong><\/p>\n<ul>\n<li>Xu\u1ea5t \u0111\u1ed9 1\/10.000 &#8211; 1\/25.000 tr\u01b0\u1eddng h\u1ee3p sinh s\u1ed1ng<\/li>\n<li>C\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng gi\u1ed1ng nh\u01b0 thai ngo\u00e0i t\u1eed cung \u1edf \u1ed1ng d\u1eabn tr\u1ee9ng<\/li>\n<li>S\u1edd b\u1ee5ng c\u00f3 th\u1ec3 c\u00f3 th\u1ec3 ch\u1ea1m c\u00e1c ph\u1ea7n thai n\u1eb1m s\u00e1t th\u00e0nh b\u1ee5ng<\/li>\n<li>50 &#8211; 70% tr\u01b0\u1eddng h\u1ee3p c\u00f3 ng\u00f4i thai b\u1ea5t th\u01b0\u1eddng<\/li>\n<li>Kh\u00e1m \u00e2m \u0111\u1ea1o k\u1ebft h\u1ee3p kh\u00e1m b\u1ee5ng: ph\u00e1t hi\u1ec7n thai n\u1eb1m b\u00ean ngo\u00e0i m\u1ed9t t\u1eed cung k\u00edch th\u01b0\u1edbc b\u00ecnh th\u01b0\u1eddng<\/li>\n<\/ul>\n<p><strong>2.5 Thai \u1edf c\u1ed5 t\u1eed cung<\/strong><\/p>\n<ul>\n<li>Chi\u1ebfm kho\u1ea3ng 1\/9.000 &#8211; 1\/12.000<\/li>\n<\/ul>\n<p><strong>2.6 Thai \u1edf bu\u1ed3ng tr\u1ee9ng<\/strong><\/p>\n<ul>\n<li>CHi\u1ebfm 1\/7.000-1\/40.000 thai k\u1ef3. Tri\u1ec7u ch\u1ee9ng gi\u1ed1ng nh\u01b0 TNTC \u1edf nh\u1eefng v\u1ecb tr\u00ed kh\u00e1c.<\/li>\n<\/ul>\n<h2><strong>3. C\u00e1c x\u00e9t nghi\u1ec7m l\u00e2ng s\u00e0ng gi\u00fap ch\u1ea9n \u0111o\u00e1n\u00a0<\/strong><\/h2>\n<ul>\n<li>\u0110inh l\u01b0\u1ee3ng B-hCG<\/li>\n<li>Si\u00eau \u00e2m<\/li>\n<li>N\u1ed9i soi \u1ed5 b\u1ee5ng<\/li>\n<li>H\u00fat\/n\u1ea1o sinh thi\u1ebft bu\u1ed3ng t\u1eed cung<\/li>\n<li>X quang kh\u00f4ng chu\u1ea9n b\u1ecb<\/li>\n<li>Ch\u1ecdc d\u00f2 cung \u0111\u1ed3<\/li>\n<\/ul>\n<p>T\u00f9y thu\u1ed9c v\u00e0o t\u00ecnh tr\u1ea1ng c\u1ee7a thai v\u00e0 s\u1ef1 hi\u1ec7u qu\u1ea3 c\u1ee7a c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n, c\u00e1c x\u00e9t nghi\u1ec7m ho\u1eb7c ph\u01b0\u01a1ng ph\u00e1p h\u00ecnh \u1ea3nh c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ed9c l\u1eadp ho\u1eb7c k\u1ebft h\u1ee3p \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n thai ngo\u00e0i t\u1eed cung.<\/p>\n<h2>4. \u0110i\u1ec1u tr\u1ecb thai ngo\u00e0i t\u1eed cung<\/h2>\n<p><strong>4.1 \u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa<\/strong><\/p>\n<p><strong>4.1.1 \u0110i\u1ec1u ki\u1ec7n \u0111i\u1ec1u tr\u1ecb Methotrexate (MTX) \u0111\u01a1n li\u1ec1u<\/strong><\/p>\n<ul>\n<li>Huy\u1ebft \u0111\u1ed9ng h\u1ecdc \u1ed5n \u0111\u1ecbnh (kh\u00f4ng s\u1ed1c)<\/li>\n<li>b- hCG nh\u1ecf h\u01a1n ho\u1eb7c b\u1eb1ng 5.000 mUI\/ml<\/li>\n<li>K\u00edch th\u01b0\u1edbc kh\u1ed1i thai &lt;4 cm (qua si\u00eau \u00e2m)<\/li>\n<li>Kh\u00f4ng c\u00f3 ph\u00f4i thai, ti thai trong kh\u1ed1i TNTC (qua si\u00eau \u00e2m)<\/li>\n<\/ul>\n<p><strong>4.1.2 \u0110i\u1ec1u ki\u1ec7n \u0111i\u1ec1u tr\u1ecb Methotrexate (MTX) li\u1ec1u \u0111\u00f4i<\/strong><\/p>\n<ul>\n<li>Huy\u1ebft \u0111\u1ed9ng h\u1ecdc \u1ed5n \u0111\u1ecbnh<\/li>\n<li>b- hCG t\u1eeb 3.500 mUI\/ml \u0111\u1ebfn nh\u1ecf h\u01a1n ho\u1eb7c b\u1eb1ng 5.500 mUI\/ml<\/li>\n<li>K\u00edch th\u01b0\u1edbc kh\u1ed1i thai &lt;4 cm (qua si\u00eau \u00e2m)<\/li>\n<li>Kh\u00f4ng c\u00f3 ph\u00f4i thai, ti thai trong kh\u1ed1i TNTC (qua si\u00eau \u00e2m)<\/li>\n<\/ul>\n<p><strong>4.1.3 \u0110i\u1ec1u ki\u1ec7n \u0111i\u1ec1u tr\u1ecb Methotrexate (MTX) \u0111a li\u1ec1u c\u1ed1 \u0111\u1ecbnh<\/strong><\/p>\n<ul>\n<li>Huy\u1ebft \u0111\u1ed9ng h\u1ecdc \u1ed5n \u0111\u1ecbnh<\/li>\n<li>b- hCG &gt; 5.500 mUI\/ml v\u00e0 b\u00e9 h\u01a1n ho\u1eb7c b\u1eb1ng 10.000 mIU\/mL<\/li>\n<li>K\u00edch th\u01b0\u1edbc kh\u1ed1i thai &lt;5 cm (qua si\u00eau \u00e2m)<\/li>\n<li>TNTC \u0111o\u1ea1n k\u1ebd &lt; 3 cm<\/li>\n<\/ul>\n<p><strong>4.1.4 Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa<\/strong><\/p>\n<ul>\n<li>Huy\u1ebft \u0111\u1ed9ng h\u1ecdc kh\u00f4ng \u1ed5n \u0111\u1ecbnh, c\u00f3 d\u1ea5u hi\u1ec7u cho\u00e1n, Hb\/Hct gi\u1ea3m<\/li>\n<li>C\u00f3 d\u1ea5u hi\u1ec7u v\u1ee1: \u0111au b\u1ee5ng d\u01b0\u1edbi nhi\u1ec1u v\u00e0 t\u0103ng d\u1ea7n, si\u00eau \u00e2m l\u01b0\u1ee3ng d\u1ecbch \u1ed5 b\u1ee5ng \u01b0\u1edbc l\u01b0\u1ee3ng &gt;300 ml hay c\u00f3 d\u1ecbch \u1ed5 b\u1ee5ng<\/li>\n<li>C\u00f3 ph\u1ed1i h\u1ee3p th\u00eam thai trong t\u1eed cung<\/li>\n<li>\u0110ang cho con b\u00fa<\/li>\n<li>D\u1ecb \u1ee9ng MTC<\/li>\n<li>C\u00d3 c\u00e1c b\u1ec7nh n\u1ed9i khoa: suy gan, suy th\u1eadn, lo\u00e9t d\u1ea1 d\u00e0y, suy gi\u1ea3m mi\u1ec5n d\u1ecbch, suy tu\u1ef7,..<\/li>\n<li>Ng\u01b0\u1eddi b\u1ec7nh t\u1eeb ch\u1ed1i \u0111i\u1ec1u tr\u1ecb MTX ho\u1eb7c kh\u00f4ng th\u1ec3 theo d\u00f5i l\u00e2u d\u00e0i<\/li>\n<li>B\u1ea5t th\u01b0\u1eddng x\u00e9t nghi\u1ec7m ti\u1ec1n ho\u00e1 tr\u1ecb (b\u1ea1ch c\u1ea7u &lt; 3000\/mm^3, ti\u1ec1u c\u1ea7m &lt; 100.000\/mm^3, t\u0103ng men gan SGOT, SGPT &gt; 100 UI\/l, t\u0103ng BUN creation, r\u1ed1i lo\u1ea1i \u0111\u1ed9ng m\u00e1u,..)<\/li>\n<\/ul>\n<p><strong>4.1.5 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n c\u1ee7a MTX<\/strong><\/p>\n<ul>\n<li>Tri\u1ec7u ch\u1ee9ng \u0111\u01b0\u1eddng ti\u00eau ho\u00e1: bu\u1ed3n n\u00f4n, n\u00f4n, vi\u00eam ni\u00eam m\u1ea1c mi\u1ec7ng th\u01b0\u1eddng g\u1eb7p sau nhi\u1ec1u li\u1ec1u MTX<\/li>\n<li>Xu\u1ea5t huy\u1ebft \u00e2m \u0111\u1ea1o l\u01b0\u1ee3ng \u00edt<\/li>\n<li>\u0110au b\u1ee5ng th\u01b0\u1eddng g\u1eb7p sau ti\u00eau MTX 2-3 ng\u00e0y. N\u1ebfu lo\u1ea1i tr\u1eeb \u0111au b\u1ee5ng do v\u1ee1 \u1ed1ng d\u1eabn tr\u1ee9ng v\u00e0 huy\u1ebft \u0111\u1ed9ng h\u1ecdc \u1ed5n \u0111\u1ecbnh th\u00ec theo d\u00f5i Hemoglobin v\u00e0 l\u01b0\u1ee3ng d\u1ecbch \u1ed5 b\u1ee5ng qua si\u00eau \u00e2m<\/li>\n<li>T\u0103ng men gan th\u01b0\u1eddng th\u1edf v\u1ec1 b\u00ecnh th\u01b0\u1eddng sau khi ng\u1eebng ti\u00eam MTX<\/li>\n<li>R\u1ee5ng t\u00f3c: hi\u1ebfm g\u1eb7p<\/li>\n<li>Vi\u00eam ph\u1ed5i: Ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n b\u00e1o v\u1edbi b\u00e1c s\u0129 kh\u00ed c\u00f3 s\u1ed1t ho\u1eb7c b\u1ea5t c\u1ee9 tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p<\/li>\n<\/ul>\n<p><strong>4.1.6 L\u01b0u \u00fd khi \u0111i\u1ec1u tr\u1ecb MTX<\/strong><\/p>\n<ul>\n<li>N\u00ean tr\u00e1nh c\u00e1c ho\u1ea1t \u0111\u1ed9ng th\u1ec3 l\u1ef1c m\u1ea1nh v\u00e0 kh\u00f4ng quan h\u1ec7 t\u00ecnh d\u1ee5c cho \u0111\u1ebfn khi \u0111i\u1ec1u tr\u1ecb kh\u1ecfi v\u00ec nguy c\u01a1 v\u1ee1 TNTC<\/li>\n<li>Kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng c\u00e1c th\u1ef1c ph\u1ea9m ho\u1eb7c thu\u1ed1c c\u00f3 ch\u1ee9a acid folic, thu\u1ed1c kh\u00e1ng vi\u00eam kh\u00f4ng steroid trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb v\u00ec c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m hi\u1ec7u qu\u1ea3 MTX<\/li>\n<li>Tr\u00e1nh ti\u1ebfp x\u00fac \u00e1nh n\u1eafng m\u1eb7t tr\u1eddi trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb h\u1ea1n ch\u1ebf nguy c\u01a1 vi\u00eam da do MTX<\/li>\n<li>Khuy\u1ebfn c\u00e1o tr\u00ec ho\u00e3n mang thai \u00edt nh\u1ea5t 3 th\u00e1ng sau li\u1ec1u MTX cu\u1ed1i c\u00f9ng<\/li>\n<li>Si\u00eau \u00e2m kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh th\u01b0\u1eddng quy \u0111\u1ec3 theo d\u00f5i \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb<\/li>\n<\/ul>\n<p><strong>4.2 \u0110i\u1ec1u tr\u1ecb ngo\u1ea1i khoa TNTC t\u1ea1i \u1ed1ng d\u1eabn tr\u1ee9ng<\/strong><\/p>\n<p><strong>4.2.1 PTNS b\u1ea3o t\u1ed3n \u1ed1ng d\u1eabn tr\u1ee9ng: x\u00e9 \u1ed1ng d\u1eabn tr\u1ee9ng l\u1ea5y kh\u1ed1i thai<\/strong><\/p>\n<p>\u0110i\u1ec1u ki\u1ec7n l\u00e0:<\/p>\n<ul>\n<li>b &#8211; hCG &lt;5.000 mUI\/ml<\/li>\n<li>Kh\u00edch th\u01b0\u1edbc t\u00fai thai &lt;4 cm<\/li>\n<li>Kh\u00f4ng c\u00f3 tim thai<\/li>\n<li>Kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed t\u1ea1o h\u00ecnh tr\u00ean \u1ed1ng d\u1eabn tr\u1ee9ng<\/li>\n<\/ul>\n<p><strong>4.2.2 Ph\u1eabu thu\u1eadt n\u1ed9i soi c\u1eaft \u1ed1ng d\u1eabn tr\u1ee9ng<\/strong><\/p>\n<ul>\n<li>Huy\u1ebft \u0111\u1ed9ng kh\u00f4ng \u1ed5n \u0111\u1ecbnh, c\u00f3 tri\u1ec7u ch\u1ee9ng v\u1ee1 c\u1ee7a kh\u1ed1i TNTC ho\u1eb7c d\u1ea5u hi\u1ec7u ch\u1ea3y m\u00e1u trong \u1ed5 b\u1ee5ng: \u0111au b\u1ee5ng nhi\u1ec1u, d\u1ecbch \u1ed5 b\u1ee5ng,..<\/li>\n<li>C\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh ho\u1eb7c th\u1ea5t b\u1ea1i v\u1edbi \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa MTX<\/li>\n<li>C\u00f3 ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt \u0111i k\u00e8m nh\u01b0: \u0111o\u1ea1n s\u1ea3n, c\u1eaft \u1ed1ng d\u1eabn tr\u1ee9ng b\u1ecb \u1ee9 d\u1ecbch v\u00e0 chu\u1ea9n b\u1ecb TTTON<\/li>\n<\/ul>\n<p><strong>4.2.3 Ph\u1eabu thu\u1eadt n\u1ed9i soi l\u1ea5y kh\u1ed1i thai ho\u1eb7c x\u1ebb\/c\u1eaft x\u00e9n g\u00f3c t\u1eed cung tr\u01b0\u1eddng h\u1ee3p kh\u1ed1i thai \u1edf \u0111o\u1ea1n k\u1ebd<\/strong><\/p>\n<p><strong>4.2.3 Khi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 cho\u00e1ng m\u1ea5t m\u00e1u ph\u1ea3i ph\u1eabu thu\u1eadt m\u1ed5 b\u1ee5ng m\u1edf, kh\u00f4ng th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt n\u1ed9i soi<\/strong><\/p>\n<p>Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y T\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Thai ngo\u00e0i t\u1eed cung l\u00e0 t\u00ecnh tr\u1ea1ng ph\u00f4i ph\u00e1t tri\u1ec3n \u1edf ngo\u00e0i t\u1eed cung, th\u01b0\u1eddng l\u00e0 trong \u1ed1ng d\u1eabn, tr\u00ean bu\u1ed3ng tr\u1ee9ng ho\u1eb7c ngo\u00e0i n\u1ed9i m\u1ea1c t\u1eed cung. \u0110\u00e2y l\u00e0 m\u1ed9t trong nh\u1eefng bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m nh\u1ea5t c\u1ee7a thai k\u1ef3 v\u00e0 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng \u0111e d\u1ecda \u0111\u1ebfn t\u00ednh m\u1ea1ng c\u1ee7a [&hellip;]<\/p>\n","protected":false},"author":49,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[13,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - 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