{"id":29757,"date":"2023-04-30T11:57:16","date_gmt":"2023-04-30T04:57:16","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29757"},"modified":"2023-05-07T09:55:17","modified_gmt":"2023-05-07T02:55:17","slug":"say-thai-lien-tiep-chan-doan-dieu-tri","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/30\/say-thai-lien-tiep-chan-doan-dieu-tri\/","title":{"rendered":"S\u1ea9y thai li\u00ean ti\u1ebfp: ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"<p><strong>S\u1ea9y thai li\u00ean ti\u1ebfp l\u00e0 hi\u1ec7n t\u01b0\u1ee3ng c\u00f3 t\u1eeb 2 l\u1ea7n s\u1ea9y thai li\u00ean t\u1ee5c tr\u1edf l\u00ean, thai nhi b\u1ecb t\u1ed1ng xu\u1ea5t kh\u1ecfi bu\u1ed3ng t\u1eed cung tr\u01b0\u1edbc 22 tu\u1ea7n.\u00a0Nguy c\u01a1 thay \u0111\u1ed5i t\u00f9y theo s\u1ed1 l\u1ea7n s\u1ea9y thai, \u0111\u00e3 t\u1eebng sinh con c\u00f2n s\u1ed1ng v\u00e0 c\u00f3 con b\u1ecb d\u1ecb t\u1eadt hay kh\u00f4ng<\/strong><\/p>\n<h2>1. Ch\u1ea9n \u0111o\u00e1n s\u1ea9y thai li\u00ean ti\u1ebfp<\/h2>\n<p><strong>1.1 L\u00e2m s\u00e0ng\u00a0<\/strong><\/p>\n<ul>\n<li>Ph\u1ea7n l\u1edbn ng\u01b0\u1eddi b\u1ec7nh \u0111\u1ebfn kh\u00e1m khi \u0111ang c\u00f3 thai v\u1edbi ti\u1ec1n s\u1eed s\u1ea9y thai, hay c\u00f3 ti\u1ec1n s\u1eed s\u1ea9y thai li\u00ean ti\u1ebfp<\/li>\n<li>\u1ede ngo\u00e0i th\u1eddi k\u1ef3 mang thai, kh\u00e1m l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c m\u1ed9t s\u1ed1 nguy\u00ean nh\u00e2n g\u00e2y s\u1ea9y thai li\u00ean ti\u1ebfp nh\u01b0 u x\u01a1 t\u1eed cung, h\u1edf eo t\u1eed cung, t\u1eed cung nhi t\u00ednh, t\u1eed cung d\u1ecb d\u1ea1ng, m\u1eb9 c\u00f3 b\u1ec7nh l\u00fd to\u00e0n th\u00e2n<\/li>\n<\/ul>\n<figure id=\"attachment_2146\" aria-describedby=\"caption-attachment-2146\" style=\"width: 300px\" class=\"wp-caption alignnone\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-2146\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-7-300x300.png\" alt=\"S\u1ea3y thai \" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-7-300x300.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-7-1024x1024.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-7-150x150.png 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-7-768x768.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/Thiet-ke-chua-co-ten-7.png 1080w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-2146\" class=\"wp-caption-text\">S\u1ea3y thai li\u00ean ti\u1ebfp<\/figcaption><\/figure>\n<p><strong>1.2 C\u1eadn l\u00e2m s\u00e0ng\u00a0<\/strong><\/p>\n<ul>\n<li><strong><em>Nhi\u1ec5m s\u1eafc \u0111\u1ed3 <\/em><\/strong><\/li>\n<\/ul>\n<p>C\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c b\u1ea5t th\u01b0\u1eddng s\u1ed1 l\u01b0\u1ee3ng hay c\u1ea5u tr\u00fac nhi\u1ec5m s\u1eafc th\u1ec3 c\u1ee7a m\u1ed9t hay 2 v\u1ee3 ch\u1ed3ng c\u00f3 ti\u1ec1n s\u1eed s\u1ea9y thai li\u00ean ti\u1ebfp.<\/p>\n<ul>\n<li><strong><em>Kh\u00e1ng th\u1ec3 kh\u00e1ng phospholipid <\/em><\/strong>\n<ul>\n<li>aPL: antiPhosphoLipid antibody: IgM v\u00e0 IgG<\/li>\n<li>aCL: antiCardioLipin antibody: IgM v\u00e0 IgG<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>+ D\u01b0\u01a1ng t\u00ednh: IgM v\u00e0 IgG cao h\u01a1n trung b\u00ecnh k\u00e9o d\u00e0i &gt; 6 tu\u1ea7n<\/p>\n<ul>\n<li>LA: Lupus Anticoagulant antibody<\/li>\n<\/ul>\n<p>+ D\u01b0\u01a1ng t\u00ednh: khi n\u1ed3ng \u0111\u1ed9 cao h\u01a1n m\u1ee9c trung b\u00ecnh k\u00e9o d\u00e0i &gt; 6 tu\u1ea7n<\/p>\n<p>+ Nh\u1ea1y c\u1ea3m v\u1edbi c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u00f3 ti\u1ec1n s\u1eed huy\u1ebft kh\u1ed1i &#8211; 2-GpI: Anti beta 2 Glycoprotein I:<\/p>\n<p>+ Gi\u00e1 tr\u1ecb ti\u00ean \u0111o\u00e1n d\u01b0\u01a1ng t\u00ednh cao (87,5%)<\/p>\n<ul>\n<li>Kh\u00e1c: kh\u00e1ng th\u1ec3 kh\u00e1ng nh\u00e2n, kh\u00e1ng th\u1ec3 kh\u00e1ng DNA\u2026<\/li>\n<li>Kh\u00f4ng th\u00f4ng d\u1ee5ng+ \u00c1p d\u1ee5ng trong APS th\u1ee9 ph\u00e1tTr\u00ean l\u00e2m s\u00e0ng, x\u00e9t nghi\u1ec7m aPL v\u00e0 aCL th\u1ef1c hi\u1ec7n tr\u01b0\u1edbc, n\u1ebfu hai x\u00e9t nghi\u1ec7m n\u00e0y \u00e2m t\u00ednh s\u1ebd ti\u1ebfp t\u1ee5c th\u1eed v\u1edbi LA v\u00e0 2-GpI. H\u1ed9i ch\u1ee9ng kh\u00e1ng PhosphoLipid \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n l\u00e0 d\u01b0\u01a1ng t\u00ednh n\u1ebfu c\u00f3 \u00edt nh\u1ea5t m\u1ed9t trong c\u00e1c x\u00e9t nghi\u1ec7m tr\u00ean d\u01b0\u01a1ng t\u00ednh.\n<p>\u0099 C\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c<\/p>\n<ul>\n<li>Si\u00eau \u00e2m: \u0111\u1ec3 ph\u00e1t hi\u1ec7n c\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u1ea5t th\u01b0\u1eddng \u1edf t\u1eed cung nh\u01b0 u x\u01a1 t\u1eed cung, t\u1eed cung d\u1ecb d\u1ea1ng, t\u1eed cung nhi t\u00ednh\u2026<\/li>\n<li>Ch\u1ee5p t\u1eed cung: ph\u00e1t hi\u1ec7n t\u1eed cung d\u1ecb d\u1ea1ng, t\u1eed cung c\u00f3 v\u00e1ch ng\u0103n, d\u00ednh bu\u1ed3ng t\u1eed cung&#8230;<\/li>\n<li>X\u00e9t nghi\u1ec7m n\u1ed9i ti\u1ebft: t\u00ecm m\u1ed9t s\u1ed1 nh\u1eefng r\u1ed1i lo\u1ea1n n\u1ed9i ti\u1ebft nh\u01b0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, b\u1ec7nh tuy\u1ebfn gi\u00e1p, suy ho\u00e0ng th\u1ec3 s\u1edbm\u2026<\/li>\n<li>M\u1ed9t s\u1ed1 x\u00e9t nghi\u1ec7m vi\u00eam nhi\u1ec5m kh\u00e1c: Toxoplasma, CMV, giang mai\u2026<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2>2. \u0110i\u1ec1u tr\u1ecb<\/h2>\n<p>D\u1ef1a v\u00e0o nguy\u00ean nh\u00e2n g\u00e2y s\u1ea9y thai li\u00ean ti\u1ebfp<\/p>\n<p><strong>2. 1 R\u1ed1i lo\u1ea1n nhi\u1ec5m s\u1eafc th\u1ec3 <\/strong><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>T\u01b0 v\u1ea5n v\u1ec1 di truy\u1ec1n xem ng\u01b0\u1eddi b\u1ec7nh c\u00f3 n\u00ean c\u00f3 thai n\u1eefa hay kh\u00f4ng.<\/li>\n<li>Tr\u01b0\u1eddng h\u1ee3p c\u00f3 thai t\u1ef1 nhi\u00ean: ti\u1ebfn h\u00e0nh c\u00e1c x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n tr\u01b0\u1edbc sinh, ch\u1ecdc \u1ed1i ho\u1eb7c sinh thi\u1ebft gai rau cho t\u1ea5t c\u1ea3 thai k\u1ef3 c\u00f3 b\u1ed1 ho\u1eb7c m\u1eb9 mang b\u1ea5t th\u01b0\u1eddng nhi\u1ec5m s\u1eafc th\u1ec3 (NST).<\/li>\n<li>Trong th\u1ee5 tinh trong \u1ed1ng nghi\u1ec7m: ti\u1ebfn h\u00e0nh sinh thi\u1ebft ch\u1ea9n \u0111o\u00e1n ti\u1ec1n ph\u00f4i (k\u1ef9 thu\u1eadt PGD) nh\u1eb1m lo\u1ea1i b\u1ecf nh\u1eefng ph\u00f4i mang b\u1ea5t th\u01b0\u1eddng di truy\u1ec1n g\u00e2y s\u1ea9y thai ho\u1eb7c c\u00f3 nguy c\u01a1 g\u00e2y d\u1ecb t\u1eadt b\u1ea9m sinh cao.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>2.2 H\u1ed9i ch\u1ee9ng kh\u00e1ng PhosphoLipid <\/strong><\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>C\u00e1c thu\u1ed1c s\u1eed d\u1ee5ng trong H\u1ed9i ch\u1ee9ng kh\u00e1ng PhosphoLipid<\/li>\n<li><u>Thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u:<\/u> Heparin tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed th\u1ea5p ho\u1eb7c Heparin kh\u00f4ng \u0111\u1ee9t \u0111o\u1ea1n .Th\u1eddi gian t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i \u2192 ti\u00eam 1 l\u1ea7n\/ng\u00e0y+ Fraxiparin 50 \u2013 60UI\/kg\/ng\u00e0y (b\u01a1m 0,3ml\/ng\u00e0y &#8211; 2850UI, ti\u00eam d\u01b0\u1edbi da b\u1ee5ng)+ Lovenox 20 &#8211; 40mg\/ng\u00e0y ti\u00eam d\u01a3\u1edbi da<br \/>\n<h4><u>\u1ee8c ch\u1ebf ti\u1ec3u c\u1ea7u: Aspirin (ASA)<\/u><\/h4>\n<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb li\u1ec1u th\u1ea5p: 75 &#8211; 100mg\/ng\u00e0y\n<ul>\n<li>Theo d\u00f5i s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u, y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u<\/li>\n<li>Ng\u01b0\u1eddi b\u1ec7nh c\u00f3 gi\u1ea3m ti\u1ec3u c\u1ea7u: kh\u00f4ng n\u00ean d\u00f9ng <u>\u1ee8c ch\u1ebf mi\u1ec5n d\u1ecbch<\/u><\/li>\n<li>Th\u01b0\u1eddng s\u1eed d\u1ee5ng cho APS th\u1ee9 ph\u00e1t hay CAPS (catastrophic APS)<\/li>\n<li>Corticoid li\u1ec1u t\u1ed1i thi\u1ec3u 1mg\/kg\/ng\u00e0y (1 l\u1ecd methylped 40mg) &#8211; Gammaglobulin:<\/li>\n<\/ul>\n<p>+ C\u00e1c tr\u01a3\u1eddng h\u1ee3p qu\u00e1 n\u1eb7ng<\/p>\n<p>+ Li\u1ec1u 0,4g\/kg\/ng\u00e0ytrong 5 ng\u00e0y ho\u1eb7c 1g\/kg\/ng\u00e0y trong 2 ng\u00e0y 3.2.2.<\/li>\n<li><strong> Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb<\/strong><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>+ H\u1ed9i ch\u1ee9ng kh\u00e1ng PhosphoLipid v\u1edbi bi\u1ebfn ch\u1ee9ng s\u1ea3n khoa<\/p>\n<ul>\n<li>Trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 thai:\u00a0Kh\u00f4ng \u0111i\u1ec1u tr\u1ecb; ASA li\u1ec1u th\u1ea5p<\/li>\n<li>Trong tr\u01b0\u1eddng h\u1ee3p c\u00f3 thai: LMWH + ASA li\u1ec1u th\u1ea5p. B\u1ed5 sung Ca v\u00e0 Vitamin D<\/li>\n<\/ul>\n<p>+H\u1ed9i ch\u1ee9ng kh\u00e1ng PhosphoLipid v\u1edbi ti\u1ec1n s\u1eed huy\u1ebft kh\u1ed1i<\/p>\n<ul>\n<li>Trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 thai: Warfarin, duy tr\u00ec INR: 2 \u2013 3<\/li>\n<li>Trong tr\u01b0\u1eddng h\u1ee3p c\u00f3 thai: ASA li\u1ec1u th\u1ea5p + Li\u1ec1u. LMWH t\u1ed1i \u0111a m\u00e0 kh\u00f4ng qua \u0111\u01b0\u1ee3c rau thai (g\u1ea5p 3 &#8211; 4 l\u1ea7n)<\/li>\n<\/ul>\n<p>+H\u1ed9i ch\u1ee9ng kh\u00e1ng PhosphoLipid th\u1ee9 ph\u00e1t hay CAPS<\/p>\n<ul>\n<li>Trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 thai: \u0110i\u1ec1u tr\u1ecb theo chuy\u00ean khoa<\/li>\n<li>Trong tr\u01b0\u1eddng h\u1ee3p c\u00f3 thai: \u1ee8c ch\u1ebf mi\u1ec5n d\u1ecbch n\u1ebfu c\u1ea7n thi\u1ebft \u2192 LMWH + ASA<\/li>\n<\/ul>\n<p><strong>Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb\u00a0<\/strong><\/p>\n<p>+ ASA: ngay khi th\u1eed hCG (+) n\u1ebfu tr\u01b0\u1edbc \u0111\u00f3 kh\u00f4ng d\u00f9ng<\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>D\u1eebng b\u1ea5t c\u1ee9 khi n\u00e0o sau 36 tu\u1ea7n, n\u00ean d\u1eebng 7 &#8211; 10 ng\u00e0y tr\u01b0\u1edbc khi l\u1ea5y thai<\/li>\n<li>Thai ph\u1ee5 c\u00f3 ti\u1ec1n s\u1eed huy\u1ebft kh\u1ed1i: ti\u1ebfp t\u1ee5c d\u00f9ng ASA trong, sau \u0111\u1ebb (d\u1ef1 ph\u00f2ng huy\u1ebft kh\u1ed1i quan tr\u1ecdng h\u01a1n so v\u1edbi ch\u1ea3y m\u00e1u v\u00ec ASA)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Kh\u00f4ng c\u00f3 m\u1ed1i li\u00ean quan gi\u1eefa ASA li\u1ec1u th\u1ea5p v\u00e0 b\u1ec7nh l\u00fd \u0111\u00f3ng s\u1edbm \u1ed1ng \u0111\u1ed9ng m\u1ea1ch, ch\u1ea3y m\u00e1u sau \u0111\u1ebb<\/li>\n<\/ul>\n<p>+ LMWH: d\u00f9ng khi si\u00eau \u00e2m c\u00f3 tim thai hay ngay khi c\u00f3 thai<\/p>\n<ul>\n<li>Su\u1ed1t th\u1eddi k\u1ef3 c\u00f3 thai v\u00e0 d\u1eebng tr\u01b0\u1edbc khi l\u1ea5y thai 24h (\u0111ang nghi\u00ean c\u1ee9u)<\/li>\n<li>APS c\u00f3 ti\u1ec1n s\u1eed s\u1ea9y thai, thai ch\u1ebft l\u01b0u &lt; 3 th\u00e1ng + kh\u00f4ng ti\u1ec1n s\u1eed huy\u1ebft kh\u1ed1i, Doppler b\u00ecnh th\u01b0\u1eddng \u1edf tu\u1ed5i thai 34 tu\u1ea7n c\u00f3 th\u1ec3 d\u1eebng LMWH<\/li>\n<li>Th\u1eddi k\u1ef3 sau sinh: d\u00f9ng LMWH k\u00e9o d\u00e0i sau \u0111\u1ebb 6 &#8211; 12 tu\u1ea7n, sau \u0111\u00f3 c\u00f3 th\u1ec3 thay b\u1eb1ng warfarin v\u00e0 theo d\u00f5i INR<\/li>\n<\/ul>\n<p><strong>2.3 Qu\u1ea3n l\u00fd thai ngh\u00e9n<\/strong><\/p>\n<ul>\n<li>T\u01b0 v\u1ea5n k\u1ef9 v\u1ec1 b\u1ec7nh l\u00fd n\u00e0y \u0111\u1ec3 ng\u01b0\u1eddi b\u1ec7nh c\u00f9ng theo d\u00f5i: D\u1ea5u hi\u1ec7u c\u1ee7a huy\u1ebft kh\u1ed1i c\u00e1c v\u1ecb tr\u00ed, d\u1ea5u hi\u1ec7u c\u1ee7a ti\u1ec1n s\u1ea3n gi\u1eadt, thai ch\u1eadm ph\u00e1t tri\u1ec3n trong t\u1eed cung, s\u1ea9y thai, thai l\u01b0u v\u00e0 d\u1ea5u hi\u1ec7u c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c<\/li>\n<li>Theo d\u00f5i thai: si\u00eau \u00e2m Doppler 3 tu\u1ea7n\/l\u1ea7n t\u1eeb tu\u1ed5i thai 18 tu\u1ea7n (n\u1ebfu thai b\u00ecnh th\u01b0\u1eddng), hay theo ch\u1ec9 \u0111\u1ecbnh n\u1ebfu Doppler n\u1ebfu c\u00f3 d\u1ea5u hi\u1ec7u b\u1ea5t th\u01b0\u1eddng. Theo d\u00f5i monitoring s\u1ea3n khoa th\u01b0\u1eddng xuy\u00ean t\u1eeb tu\u1ed5i thai 20 tu\u1ea7n<\/li>\n<li>Theo d\u00f5i t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c (ti\u1ec3u c\u1ea7u, APPT): 3 tu\u1ea7n \u0111\u1ea7u 1l\u1ea7n \/ tu\u1ea7n.<\/li>\n<\/ul>\n<p>Sau \u0111\u00f3 4 tu\u1ea7n\/l\u1ea7n (n\u1ebfu kh\u00f4ng c\u00f3 b\u1ea5t th\u01b0\u1eddng)<\/p>\n<p><strong>2.4 K\u1ebft th\u00fac thai ngh\u00e9n<\/strong><\/p>\n<ul>\n<li>Th\u1eddi \u0111i\u1ec3m k\u1ebft th\u00fac thai ngh\u00e9n: PARA + can thi\u1ec7p s\u1edbm<\/li>\n<\/ul>\n<p>+ Thai b\u00ecnh th\u01b0\u1eddng: \u1edf tu\u1ed5i thai 39 tu\u1ea7n<\/p>\n<p>+ Thai c\u00f3 bi\u1ebfn ch\u1ee9ng: ti\u1ec1n s\u1ea3n gi\u1eadt, thai ch\u1eadm ph\u00e1t tri\u1ec3n trong t\u1eed cung theo ch\u1ec9 \u0111\u1ecbnh s\u1ea3n khoa + PARA + can thi\u1ec7p s\u1edbm.<\/p>\n<ul>\n<li>Ph\u01b0\u01a1ng ph\u00e1p k\u1ebft th\u00fac thai ngh\u00e9n: theo ch\u1ec9 \u0111\u1ecbnh c\u1ee7a s\u1ea3n khoa<\/li>\n<\/ul>\n<ul>\n<li>Gi\u1ea3m \u0111au trong APS ch\u1ec9 \u0111\u1ecbnh binh th\u01b0\u1eddng n\u00ean d\u1eebng LMWH tr\u01b0\u1edbc 24h, x\u00e9t nghi\u1ec7m \u0111\u00f4ng m\u00e1u b\u00ecnh th\u01b0\u1eddng, ti\u1ec3u c\u1ea7u &gt; 70G\/l<\/li>\n<\/ul>\n<p><strong>2.5 \u0110i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n kh\u00e1c <\/strong><\/p>\n<ul>\n<li>H\u1edf eo t\u1eed cung: kh\u00e2u v\u00f2ng c\u1ed5 t\u1eed cung, gi\u1ea3m co.<\/li>\n<\/ul>\n<p>Thi\u1ebfu h\u1ee5t n\u1ed9i ti\u1ebft: b\u1ed5 xung n\u1ed9i ti\u1ebft nh\u01a3 progesteron, estrogen.<\/p>\n<ul>\n<li>M\u1ed5 b\u00f3c nh\u00e2n x\u01a1 trong u x\u01a1 t\u1eed cung, m\u1ed5 c\u1eaft v\u00e1ch ng\u0103n t\u1eed cung\u2026<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd to\u00e0n th\u00e2n c\u1ee7a m\u1eb9 nh\u01b0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, giang mai, vi\u00eam th\u1eadn hay c\u00e1c b\u1ec7nh n\u1ed9i ti\u1ebft nh\u01b0 thi\u1ec3u n\u0103ng gi\u00e1p tr\u1ea1ng, basedow\u2026<\/li>\n<\/ul>\n<p>Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"<p>S\u1ea9y thai li\u00ean ti\u1ebfp l\u00e0 hi\u1ec7n t\u01b0\u1ee3ng c\u00f3 t\u1eeb 2 l\u1ea7n s\u1ea9y thai li\u00ean t\u1ee5c tr\u1edf l\u00ean, thai nhi b\u1ecb t\u1ed1ng xu\u1ea5t kh\u1ecfi bu\u1ed3ng t\u1eed cung tr\u01b0\u1edbc 22 tu\u1ea7n.\u00a0Nguy c\u01a1 thay \u0111\u1ed5i t\u00f9y theo s\u1ed1 l\u1ea7n s\u1ea9y thai, \u0111\u00e3 t\u1eebng sinh con c\u00f2n s\u1ed1ng v\u00e0 c\u00f3 con b\u1ecb d\u1ecb t\u1eadt hay kh\u00f4ng 1. Ch\u1ea9n \u0111o\u00e1n [&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 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>S\u1ea9y thai li\u00ean ti\u1ebfp: ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb - Vinmec<\/title>\n<meta name=\"description\" content=\"S\u1ea9y thai li\u00ean ti\u1ebfp l\u00e0 hi\u1ec7n t\u01b0\u1ee3ng c\u00f3 t\u1eeb 2 l\u1ea7n s\u1ea9y thai li\u00ean t\u1ee5c tr\u1edf l\u00ean, thai nhi b\u1ecb t\u1ed1ng xu\u1ea5t kh\u1ecfi bu\u1ed3ng t\u1eed cung tr\u01b0\u1edbc 22 tu\u1ea7n\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"S\u1ea9y thai li\u00ean ti\u1ebfp: ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb - 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