{"id":30655,"date":"2023-05-03T14:22:35","date_gmt":"2023-05-03T07:22:35","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30655"},"modified":"2023-05-03T14:30:54","modified_gmt":"2023-05-03T07:30:54","slug":"rau-bong-non-phan-loai-sinh-ly-benh-bien-chung","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/rau-bong-non-phan-loai-sinh-ly-benh-bien-chung\/","title":{"rendered":"Rau bong non: ph\u00e2n lo\u1ea1i, sinh l\u00fd b\u1ec7nh, bi\u1ebfn ch\u1ee9ng"},"content":{"rendered":"<p><strong>Rau bong non l\u00e0 rau b\u00e1m \u0111\u00fang v\u1ecb tr\u00ed nh\u01b0ng bong m\u1ed9t ph\u1ea7n hay to\u00e0n b\u1ed9 b\u00e1nh rau tr\u01b0\u1edbc khi s\u1ed5 thai. Rau bong non l\u00e0 m\u1ed9t c\u1ea5p c\u1ee9u s\u1ea3n khoa, th\u01b0\u1eddng x\u1ea3y ra \u1edf 3 th\u00e1ng cu\u1ed1i th\u1eddi k\u00ec thai ngh\u00e9n, di\u1ec5n bi\u1ebfn n\u1eb7ng \u0111e d\u1ecda t\u00ednh m\u1ea1ng c\u1ee7a thai nhi v\u00e0 s\u1ea3n ph\u1ee5.<\/strong><\/p>\n<h2>1. Ph\u00e2n lo\u1ea1i rau bong non<\/h2>\n<p>Rau bong non l\u00e0 b\u1ec7nh l\u00fd c\u1ee7a h\u1ec7 th\u1ed1ng mao m\u1ea1ch, x\u1ea3y ra \u0111\u1ed9t ng\u1ed9t c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n r\u1ea5t nhanh t\u1eeb th\u1ec3 nh\u1eb9 th\u00e0nh th\u1ec3 n\u1eb7ng<\/p>\n<p>4 th\u1ec3 theo h\u00ecnh th\u00e1i l\u00e2m s\u00e0ng:<\/p>\n<ul>\n<li style=\"list-style-type: none;\">\n<ul>\n<li>Rau bong non th\u1ec3 \u1ea9n<\/li>\n<li>Rau bong non th\u1ec3 nh\u1eb9<\/li>\n<li>Rau bong non th\u1ec3 trung b\u00ecnh<\/li>\n<li>Rau bong non th\u1ec3 n\u1eb7ng.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2>2. Sinh l\u00fd b\u1ec7nh rau bong non<\/h2>\n<p>Nguy\u00ean nh\u00e2n tr\u1ef1c ti\u1ebfp c\u1ee7a vi\u1ec7c rau bong non s\u1edbm l\u00e0 do m\u1ea1ch m\u00e1u m\u1eb9 b\u1ecb v\u1ee1 \u1edf l\u1edbp m\u00e0ng \u0111\u00e1y. Hi\u1ebfm khi ch\u1ea3y m\u00e1u b\u1eaft ngu\u1ed3n t\u1eeb m\u1ea1ch m\u00e1u nhau thai.\u00a0M\u00e1u t\u00edch t\u1ee5 s\u1ebd t\u00e1ch m\u00e0ng r\u1ee5ng, t\u00e1ch ra m\u1ed9t l\u1edbp m\u1ecfng m\u00e0ng r\u1ee5ng v\u1edbi ph\u1ea7n \u0111\u00ednh k\u00e8m nhau thai c\u1ee7a n\u00f3.<\/p>\n<p>M\u1ea1ch m\u00e1u c\u1ee7a m\u1eb9 b\u1ecb v\u1ee1 c\u00f3 th\u1ec3 l\u00e0 \u0111\u1ed9ng m\u1ea1ch ho\u1eb7c t\u0129nh m\u1ea1ch. Trong tr\u01b0\u1eddng h\u1ee3p rau bong non nghi\u00eam tr\u1ecdng c\u1ea5p t\u00ednh, xu\u1ea5t huy\u1ebft \u0111\u1ed9ng m\u1ea1ch do \u00e1p l\u1ef1c cao \u1edf khu v\u1ef1c trung t\u00e2m c\u1ee7a nhau thai chia c\u1eaft r\u1ed9ng r\u00e3i qua giao di\u1ec7n nhau thai-m\u00e0ng v\u00e0 g\u00e2y ra t\u00ecnh tr\u1ea1ng bong rau thai ho\u00e0n to\u00e0n ho\u1eb7c g\u1ea7n nh\u01b0 ho\u00e0n to\u00e0n. \u0110i\u1ec1u n\u00e0y d\u1eabn \u0111\u1ebfn s\u1ef1 ph\u00e1t tri\u1ec3n nhanh ch\u00f3ng c\u1ee7a c\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng c\u00f3 kh\u1ea3 n\u0103ng \u0111e d\u1ecda t\u00ednh m\u1ea1ng c\u1ee7a rau bong non, ch\u1eb3ng h\u1ea1n nh\u01b0 ch\u1ea3y m\u00e1u nghi\u00eam tr\u1ecdng \u1edf m\u1eb9, \u0111\u00f4ng m\u00e1u n\u1ed9i m\u1ea1ch lan t\u1ecfa \u1edf m\u1eb9 (DIC) v\u00e0 nh\u1ecbp tim thai lo\u1ea1i III.<\/p>\n<p>M\u1ed9t t\u1ef7 l\u1ec7 nh\u1ecf c\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u00e0y l\u00e0 do c\u00e1c s\u1ef1 ki\u1ec7n c\u01a1 h\u1ecdc \u0111\u1ed9t ng\u1ed9t (v\u00ed d\u1ee5: ch\u1ea5n th\u01b0\u01a1ng b\u1ee5ng k\u00edn) ho\u1eb7c do t\u1eed cung gi\u1ea3m \u00e1p nhanh ch\u00f3ng (v\u00ed d\u1ee5: sau khi sinh c\u1eb7p song sinh \u0111\u1ea7u ti\u00ean ho\u1eb7c t\u00ecnh tr\u1ea1ng \u0111a \u1ed1i nhanh ch\u00f3ng).\u00a0Nh\u1eefng s\u1ef1 ki\u1ec7n c\u1ea5p t\u00ednh n\u00e0y c\u00f3 th\u1ec3 l\u00e0m c\u0103ng b\u1ec1 m\u1eb7t gi\u1eefa c\u01a1 t\u1eed cung m\u1ec1m d\u1ebbo v\u00e0 nhau thai kh\u00f4ng \u0111\u00e0n h\u1ed3i.<\/p>\n<p>Trong nhau bong non m\u00e3n t\u00ednh, s\u1ef1 ph\u00e1t tri\u1ec3n b\u1ea5t th\u01b0\u1eddng s\u1edbm c\u1ee7a \u0111\u1ed9ng m\u1ea1ch xo\u1eafn \u1ed1c d\u1eabn \u0111\u1ebfn ho\u1ea1i t\u1eed \u0111\u1ea7u nhau, vi\u00eam nhau thai (v\u00e0 c\u00f3 th\u1ec3 nh\u1ed3i m\u00e1u), v\u00e0 cu\u1ed1i c\u00f9ng l\u00e0 xu\u1ea5t huy\u1ebft t\u0129nh m\u1ea1ch \u00e1p su\u1ea5t th\u1ea5p, \u0111i\u1ec3n h\u00ecnh l\u00e0 \u1edf ngo\u1ea1i vi c\u1ee7a nhau thai (t\u1ee9c l\u00e0, nhau bong non \u1edf r\u00eca). C\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng x\u1ea3y ra theo th\u1eddi gian v\u00e0 bao g\u1ed3m ch\u1ea3y m\u00e1u nh\u1eb9 t\u1eebng \u0111\u1ee3t, thi\u1ec3u \u1ed1i v\u00e0 h\u1ea1n ch\u1ebf t\u0103ng tr\u01b0\u1edfng c\u1ee7a thai nhi li\u00ean quan \u0111\u1ebfn ph\u00e2n ph\u1ed1i l\u1ea1i l\u01b0u l\u01b0\u1ee3ng m\u00e1u n\u00e3o (gi\u1ea3m ch\u1ec9 s\u1ed1 nh\u1ecbp \u0111\u1eadp c\u1ee7a \u0111\u1ed9ng m\u1ea1ch n\u00e3o gi\u1eefa).<\/p>\n<p>Thrombin \u0111\u00f3ng m\u1ed9t vai tr\u00f2 quan tr\u1ecdng trong c\u00e1c h\u1eadu qu\u1ea3 l\u00e2m s\u00e0ng c\u1ee7a nhau bong non, v\u00e0 c\u0169ng c\u00f3 th\u1ec3 quan tr\u1ecdng trong c\u01a1 ch\u1ebf b\u1ec7nh sinh c\u1ee7a n\u00f3. Vi\u1ec7c s\u1ea3n xu\u1ea5t thrombin c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn c\u00e1c di ch\u1ee9ng l\u00e2m s\u00e0ng sau:<\/p>\n<ul>\n<li class=\"bulletIndent1\">T\u0103ng tr\u01b0\u01a1ng l\u1ef1c t\u1eed cung v\u00e0 c\u00e1c c\u01a1n co th\u1eaft, v\u00ec thrombin l\u00e0 m\u1ed9t t\u00e1c nh\u00e2n co h\u1ed3i t\u1eed cung tr\u1ef1c ti\u1ebfp, m\u1ea1nh<\/li>\n<\/ul>\n<p class=\"bulletIndent1\">T\u0103ng c\u01b0\u1eddng bi\u1ec3u hi\u1ec7n c\u1ee7a metallicoproteinase, \u0111i\u1ec1u ch\u1ec9nh t\u0103ng c\u00e1c gen li\u00ean quan \u0111\u1ebfn qu\u00e1 tr\u00ecnh ch\u1ebft theo ch\u01b0\u01a1ng tr\u00ecnh \u00a0v\u00e0 g\u00e2y ra bi\u1ec3u hi\u1ec7n c\u1ee7a c\u00e1c cytokine g\u00e2y vi\u00eam (ch\u1ee7 y\u1ebfu l\u00e0 interleukin-8), d\u1eabn \u0111\u1ebfn ho\u1ea1i t\u1eed m\u00f4 v\u00e0 tho\u00e1i h\u00f3a ngo\u1ea1i b\u00e0o.\u00a0M\u1ed9t v\u00f2ng lu\u1ea9n qu\u1ea9n sau \u0111\u00f3 x\u1ea3y ra, d\u1eabn \u0111\u1ebfn s\u1ef1 gi\u00e1n \u0111o\u1ea1n tu\u1ea7n ho\u00e0n h\u01a1n n\u1eefa v\u00e0 th\u01b0\u1eddng d\u1eabn \u0111\u1ebfn b\u1eaft \u0111\u1ea7u chuy\u1ec3n d\u1ea1 v\u00e0 v\u1ee1 m\u00e0ng \u1ed1i<\/p>\n<p class=\"bulletIndent1\">\u1ede nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb v\u1ee1 m\u00e0ng \u1ed1i tr\u01b0\u1edbc khi chuy\u1ec3n d\u1ea1, nguy c\u01a1 bong rau t\u0103ng l\u00ean khi \u0111\u1ed9 tr\u1ec5 t\u0103ng l\u00ean, \u0111i\u1ec1u n\u00e0y cho th\u1ea5y t\u00ecnh tr\u1ea1ng vi\u00eam sau khi m\u00e0ng \u1ed1i v\u1ee1 c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra ch\u1ee9 kh\u00f4ng ch\u1ec9 \u0111\u01a1n gi\u1ea3n l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a m\u1ed9t lo\u1ea1t c\u00e1c s\u1ef1 ki\u1ec7n d\u1eabn \u0111\u1ebfn bong rau<\/p>\n<ul>\n<li class=\"bulletIndent1\">Ch\u1ea3y m\u00e1u t\u1ea1ng: N\u1ebfu m\u1ed9t l\u01b0\u1ee3ng l\u1edbn y\u1ebfu t\u1ed1 m\u00f4 (thromboplastin) \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng, th\u00ec m\u1ed9t l\u01b0\u1ee3ng l\u1edbn thrombin s\u1ebd \u0111\u01b0\u1ee3c t\u1ea1o ra v\u00e0 \u0111i v\u00e0o tu\u1ea7n ho\u00e0n c\u1ee7a ng\u01b0\u1eddi m\u1eb9 trong m\u1ed9t th\u1eddi gian ng\u1eafn. \u0110i\u1ec1u n\u00e0y l\u1ea5n \u00e1t c\u00e1c c\u01a1 ch\u1ebf ki\u1ec3m so\u00e1t c\u1ea7m m\u00e1u m\u00e0 kh\u00f4ng cho ph\u00e9p \u0111\u1ee7 th\u1eddi gian \u0111\u1ec3 ph\u1ee5c h\u1ed3i c\u00e1c c\u01a1 ch\u1ebf b\u00f9 tr\u1eeb. H\u1eadu qu\u1ea3 l\u00e2m s\u00e0ng l\u00e0 ch\u1ea3y m\u00e1u to\u00e0n th\u00e2n tr\u1ea7m tr\u1ecdng v\u00e0 do l\u1eafng \u0111\u1ecdng fibrin n\u1ed9i m\u1ea1ch lan r\u1ed9ng, t\u1ed5n th\u01b0\u01a1ng m\u00f4 do thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 v\u00e0 thi\u1ebfu m\u00e1u t\u00e1n huy\u1ebft vi m\u1ea1ch (t\u1ee9c l\u00e0 DIC).<\/li>\n<li class=\"bulletIndent1\">Gi\u1ea3m t\u00e1c d\u1ee5ng c\u1ee7a progesterone\u00a0b\u1eb1ng c\u00e1ch gi\u1ea3m th\u1ee5 th\u1ec3 progesterone trong c\u00e1c t\u1ebf b\u00e0o, l\u00e0 y\u1ebfu t\u1ed1 kh\u1edfi \u0111\u1ea7u ho\u1eb7c g\u00f3p ph\u1ea7n v\u00e0o s\u1ef1 gi\u1ea3m co b\u00f3p c\u1ee7a t\u1eed cung<\/li>\n<\/ul>\n<figure id=\"attachment_30673\" aria-describedby=\"caption-attachment-30673\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-30673\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/20190724_052030_066310_rau-bong-non.max-800x800-1-300x181.png\" alt=\"Rau bong non \" width=\"300\" height=\"181\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/20190724_052030_066310_rau-bong-non.max-800x800-1-300x181.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/20190724_052030_066310_rau-bong-non.max-800x800-1.png 500w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-30673\" class=\"wp-caption-text\">Rau bong non<\/figcaption><\/figure>\n<h2>3. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1<\/h2>\n<ul>\n<li>T\u1eebng b\u1ecb rau bong non l\u1ea7n mang thai tr\u01b0\u1edbc \u0111\u00f3: Rau bong non tr\u01b0\u1edbc \u0111\u00e2y l\u00e0 y\u1ebfu t\u1ed1 r\u1ee7i ro l\u1edbn nh\u1ea5t \u0111\u1ed1i, v\u1edbi nguy c\u01a1 t\u00e1i ph\u00e1t cao g\u1ea5p 10 \u0111\u1ebfn 15 l\u1ea7n.<\/li>\n<li>M\u1eb9 c\u00f3 ti\u1ec1n s\u1eed t\u0103ng huy\u1ebft \u00e1p, ti\u1ec1n s\u1ea3n gi\u1eadt<\/li>\n<li>B\u1ea5t th\u01b0\u1eddng c\u1ea5u tr\u00fac t\u1eed cung ng\u01b0\u1eddi m\u1eb9<\/li>\n<li>C\u00e1c b\u1ea5t th\u01b0\u1eddng y\u1ebfu t\u1ed1 di truy\u1ec1n kh\u00e1c<\/li>\n<\/ul>\n<p>C\u00f2n ra c\u00f2n c\u00f3 m\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 kh\u00e1c li\u00ean quan \u0111\u1ebfn th\u00f3i quen sinh ho\u1ea1t c\u1ee7a ng\u01b0\u1eddi m\u1eb9 nh\u01b0 ti\u1ec1n s\u1eed th\u01b0\u1eddng xuy\u00ean s\u1eed d\u1ee5ng c\u00e1c ch\u1ea5t k\u00edch th\u00edch nh\u01b0 r\u01b0\u1ee3u, thu\u1ed1c l\u00e1, cafein, cocain..<\/p>\n<h2>4. Bi\u1ebfn ch\u1ee9ng<\/h2>\n<p><strong>4.1 Bi\u1ebfn ch\u1ee9ng cho ng\u01b0\u1eddi m\u1eb9\u00a0<\/strong><\/p>\n<p>M\u1ea5t m\u00e1u qu\u00e1 nhi\u1ec1u v\u00e0 \u0111\u00f4ng m\u00e1u n\u1ed9i m\u1ea1ch lan t\u1ecfa (DIC), c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn s\u1ed1c gi\u1ea3m th\u1ec3 t\u00edch, cho\u00e1ng do m\u1ea5t m\u00e1u v\u00e0 \u0111au. T\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p, h\u1ed9i ch\u1ee9ng suy h\u00f4 h\u1ea5p \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh, suy \u0111a c\u01a1 quan, c\u1eaft t\u1eed cung sau sinh . Ho\u1ea1i t\u1eed c\u00e1c t\u1ea1ng do nh\u1ed3i m\u00e1u v\u00e0 thi\u1ebfu m\u00e1u, nguy hi\u1ec3m nh\u1ea5t l\u00e0 suy th\u1eadn.<\/p>\n<p>M\u1ed5 l\u1ea5y thai kh\u1ea9n c\u1ea5p khi c\u00f3 ch\u1ec9 \u0111\u1ecbnh c\u1ee7a thai nhi ho\u1eb7c m\u1eb9. T\u1eed vong c\u1ea3 m\u1eb9 v\u00e0 con<\/p>\n<p><strong>4.2 Bi\u1ebfn ch\u1ee9ng cho thai nhi<\/strong><\/p>\n<p>T\u0103ng t\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh v\u00e0 t\u1eed vong chu sinh li\u00ean quan \u0111\u1ebfn thi\u1ebfu oxy m\u00e1u, ng\u1ea1t, nh\u1eb9 c\u00e2n v\u00e0\/ho\u1eb7c sinh non<\/p>\n<p>H\u1ea1n ch\u1ebf t\u0103ng tr\u01b0\u1edfng\/nh\u1ecf so v\u1edbi tu\u1ed5i thai (SGA) c\u00e2n n\u1eb7ng khi sinh (khi rau bong non l\u00e0 m\u00e3n t\u00ednh)<\/p>\n<p>Trong c\u00e1c nghi\u00ean c\u1ee9u, t\u1ef7 l\u1ec7 t\u1eed vong chu sinh dao \u0111\u1ed9ng t\u1eeb 3 \u0111\u1ebfn 12 ph\u1ea7n tr\u0103m (so v\u1edbi 0,6 ph\u1ea7n tr\u0103m \u1edf c\u00e1c ca sinh kh\u00f4ng b\u1ecb s\u1ea9y).\u00a0H\u01a1n 50% tr\u01b0\u1eddng h\u1ee3p t\u1eed vong chu sinh li\u00ean quan \u0111\u1ebfn nhau bong non l\u00e0 thai ch\u1ebft l\u01b0u do ng\u1ea1t trong t\u1eed cung, th\u01b0\u1eddng x\u1ea3y ra khi h\u01a1n 45% nhau thai bong ra, \u0111\u1eb7c bi\u1ec7t l\u00e0 bong nhau trung t\u00e2m.\u00a0T\u1eed vong trong giai \u0111o\u1ea1n sau sinh ch\u1ee7 y\u1ebfu li\u00ean quan \u0111\u1ebfn sinh non<\/p>\n<p>Thai nhi b\u1ecb ng\u1ea1t, sinh non v\u00e0 h\u1ea1n ch\u1ebf t\u0103ng tr\u01b0\u1edfng c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn c\u00e1c di ch\u1ee9ng ng\u1eafn h\u1ea1n v\u00e0 d\u00e0i h\u1ea1n, v\u00e0 vi\u1ec7c s\u1ea3y thai d\u01b0\u1eddng nh\u01b0 l\u00e0m t\u0103ng nguy c\u01a1.<\/p>\n<p>Ngo\u00e0i ra c\u00f2n c\u00f3 c\u00e1c bi\u1ebfn ch\u1ee9ng li\u00ean qu\u00e1n kh\u00e1c nh\u01b0: thi\u1ebfu m\u00e1u, suy thai, thai ch\u1ebft trong t\u1eed cung, non th\u00e1ng nh\u1eb9 c\u00e2n&#8230;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Rau bong non l\u00e0 rau b\u00e1m \u0111\u00fang v\u1ecb tr\u00ed nh\u01b0ng bong m\u1ed9t ph\u1ea7n hay to\u00e0n b\u1ed9 b\u00e1nh rau tr\u01b0\u1edbc khi s\u1ed5 thai. Rau bong non l\u00e0 m\u1ed9t c\u1ea5p c\u1ee9u s\u1ea3n khoa, th\u01b0\u1eddng x\u1ea3y ra \u1edf 3 th\u00e1ng cu\u1ed1i th\u1eddi k\u00ec thai ngh\u00e9n, di\u1ec5n bi\u1ebfn n\u1eb7ng \u0111e d\u1ecda t\u00ednh m\u1ea1ng c\u1ee7a thai nhi v\u00e0 s\u1ea3n ph\u1ee5. [&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>Rau bong non: ph\u00e2n lo\u1ea1i, sinh l\u00fd b\u1ec7nh, bi\u1ebfn ch\u1ee9ng - Vinmec<\/title>\n<meta name=\"description\" content=\"Rau bong non l\u00e0 rau b\u00e1m \u0111\u00fang v\u1ecb tr\u00ed nh\u01b0ng bong m\u1ed9t ph\u1ea7n hay to\u00e0n b\u1ed9 b\u00e1nh rau tr\u01b0\u1edbc khi s\u1ed5 thai. 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