{"id":31591,"date":"2023-05-07T10:06:28","date_gmt":"2023-05-07T03:06:28","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=31591"},"modified":"2023-05-07T10:06:28","modified_gmt":"2023-05-07T03:06:28","slug":"dieu-tri-dai-thao-duong-thai-nghen","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/07\/dieu-tri-dai-thao-duong-thai-nghen\/","title":{"rendered":"\u0110i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng thai ngh\u00e9n"},"content":{"rendered":"<p><strong>\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng thai ngh\u00e9n (\u0110TNTN) l\u00e0 s\u1ef1 gi\u1ea3m dung n\u1ea1p glucose ho\u1eb7c \u0110T\u0110 (\u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng) \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n l\u1ea7n \u0111\u1ea7u trong l\u00fac mang thai (kh\u00f4ng lo\u1ea1i tr\u1eeb ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e3 c\u00f3 gi\u1ea3m dung n\u1ea1p glucose ho\u1eb7c \u0110T\u0110 t\u1eeb tr\u01b0\u1edbc nh\u01b0ng ch\u01b0a \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n).\u00a0<\/strong><\/p>\n<h2>1. \u0110i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 thai nghen<\/h2>\n<p><strong>1.1 Theo d\u00f5i v\u00e0 \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng quy : <\/strong><\/p>\n<p>\u0110\u1ed1i v\u1edbi tr\u01b0\u1eddng h\u1ee3p c\u00f3 ti\u1ec1n s\u1eed <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/tong-quan-ve-benh-dai-thao-duong\/\">\u0110T\u0110TN<\/a>: c\u1ea7n \u0111\u00e1nh gi\u00e1 l\u1ea1i kh\u1ea3 n\u0103ng dung n\u1ea1p glucose tr\u01a3\u1edbc khi mang thai \u0111\u1ec3 c\u00f3 th\u00e1i \u0111\u1ed9 th\u00edch h\u1ee3p.<\/p>\n<p>\u0110\u1ed1i v\u1edbi tr\u01b0\u1eddng h\u1ee3p \u0111\u00e3 c\u00f3 \u0110T\u0110 t\u00fdp 2 tr\u01b0\u1edbc l\u00fac mang thai: ph\u1ea3i \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng insulin.<\/p>\n<p>N\u00f3i chung t\u1ea5t c\u1ea3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111\u00e3 bi\u1ebft \u0110T\u0110 t\u1eeb tr\u01b0\u1edbc ho\u1eb7c \u0110T\u0110TN, m\u1ee5c \u0111\u00edch \u0111i\u1ec1u tr\u1ecb l\u00e0 duy tr\u00ec glucose huy\u1ebft tr\u01b0\u1edbc v\u00e0 sau \u0103n b\u00ecnh th\u01b0\u1eddng nh\u1eb1m tr\u00e1nh nh\u1eefng nguy c\u01a1 t\u1ee9c th\u1eddi v\u00e0 l\u00e2u d\u00e0i cho thai nhi.<\/p>\n<p><strong>1.1.1 Theo d\u00f5i<\/strong><\/p>\n<p>C\u1ea7n t\u00ecm ceton ni\u1ec7u tr\u01b0\u1edbc b\u1eefa \u0111i\u1ec3m t\u00e2m nh\u1eb1m xem x\u00e9t l\u01a3\u1ee3ng carbohydrate cung c\u1ea5p \u0111\u1ee7 nhu c\u1ea7u hay kh\u00f4ng. Thai ph\u1ee5 c\u00f3 \u0110T\u0110 t\u1eeb tr\u01a3\u1edbc n\u00ean t\u00ecm ceton ni\u1ec7u khi glucose &gt;150mg\/dL. V\u1edbi \u0110T\u0110TN th\u1ec9nh tho\u1ea3ng n\u00ean theo d\u00f5i glucose \u0111\u00f3i, 1 gi\u1edd, 2 gi\u1edd sau \u0103n. Ng\u01b0\u1eddi b\u1ec7nh d\u00f9ng insulin c\u1ea7n theo d\u00f5i glucose \u0111\u00f3i v\u00e0 l\u00fac \u0111i ng\u1ee7 \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u.<\/p>\n<p>T\u1ea5t c\u1ea3 \u0111\u1ed1i t\u01b0\u1ee3ng c\u1ea7n theo d\u00f5i HbA1C 3 th\u00e1ng \u0111\u1ea7u mang thai gi\u00fap \u0111\u00e1nh gi\u00e1 nguy c\u01a1 d\u1ecb t\u1eadt b\u1ea9m sinh.<\/p>\n<p><strong>1.1.2 Dinh \u0111\u01b0\u1ee1ng\u00a0<\/strong><\/p>\n<ul>\n<li>Nguy\u00ean t\u1eafc c\u01a1 b\u1ea3n nh\u1eb1m g\u00f3p ph\u1ea7n ki\u1ec3m so\u00e1t th\u1eadt ch\u1eb7t ch\u1ebd \u0110T\u0110 su\u1ed1t trong qu\u00e1 tr\u00ecnh mang thai \u0111\u00f3 l\u00e0 ch\u1ebf \u0111\u1ed9 v\u00e0 k\u1ebf ho\u1ea1ch \u0103n u\u1ed1ng.<\/li>\n<li>M\u1ed7i ng\u00e0y c\u1ea7n chia ra 3 b\u1eefa \u0103n ch\u00ednh v\u00e0 3 b\u1eefa \u0103n ph\u1ee5 nh\u1eb1m tr\u00e1nh h\u1ea1 glucose huy\u1ebft ban \u0111\u00eam v\u00e0 tr\u01b0\u1edbc c\u00e1c b\u1eefa \u0103n.<\/li>\n<\/ul>\n<p>Tr\u01b0\u1eddng h\u1ee3p b\u1ecb h\u1ea1 glucose huy\u1ebft, c\u1ea7n \u0111i\u1ec1u tr\u1ecb th\u1eadt h\u1ee3p l\u00fd, kh\u00f4ng l\u1ea1m d\u1ee5ng l\u00e0m t\u0103ng glucose th\u00e1i qu\u00e1 g\u00e2y h\u1ea1i cho thai.<\/p>\n<p>Tr\u01b0\u1eddng h\u1ee3p h\u1ea1 glucose huy\u1ebft k\u00e8m r\u1ed1i lo\u1ea1n tri gi\u00e1c c\u1ea7n ti\u00eam glucagon ( c\u00f3 th\u1ec3 h\u01b0\u1edbng d\u1eabn cho ng\u01b0\u1eddi th\u00e2n th\u1ef1c hi\u1ec7n khi c\u1ea7n).<\/p>\n<p><strong>1.2 \u0110i\u1ec1u tr\u1ecb insulin\u00a0<\/strong><\/p>\n<p>Y\u00eau c\u1ea7u \u0111i\u1ec1u tr\u1ecb: v\u1edbi \u0110T\u0110TN y\u00eau c\u1ea7u ki\u1ec3m so\u00e1t glucose ch\u1eb7t ch\u1ebd h\u01a1n so v\u1edbi ng\u01b0\u1eddi b\u1ec7nh \u0110T\u0110 n\u00f3i chung, c\u1ee5 th\u1ec3 glucose huy\u1ebft l\u00fac \u0111\u00f3i: 60-95mg\/dL, glucose huy\u1ebft sau \u0103n: 100-129mg\/dL. Ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n \u0111\u01b0\u1ee3c \u0111o glucose huy\u1ebft mao m\u1ea1ch nhi\u1ec1u l\u1ea7n m\u1ed7i ng\u00e0y t\u1ea1i nh\u00e0, t\u1ea1i n\u01a1i l\u00e0m vi\u1ec7c \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u insulin \u0111i\u1ec1u tr\u1ecb th\u1eadt th\u00edch h\u1ee3p.<\/p>\n<p>Y\u00eau c\u1ea7u glucose huy\u1ebft c\u1ee5 th\u1ec3 cho c\u00e1c giai \u0111o\u1ea1n nh\u01a3 sau:<\/p>\n<p>-Tr\u01b0\u1edbc khi mang thai: x\u00e1c \u0111\u1ecbnh glucose huy\u1ebft sau \u0103n (GHSA).<\/p>\n<p>-Ba th\u00e1ng \u0111\u1ea7u thai k\u1ef3: GHSA &lt; 160mg\/dL, gi\u00fap l\u00e0m gi\u1ea3m nguy c\u01a1 s\u1ea9y thai, gi\u1ea3m nguy c\u01a1 d\u1ecb t\u1eadt, ki\u1ec3m so\u00e1t ceton m\u00e1u.<\/p>\n<p>-Ba th\u00e1ng gi\u1eefa thai k\u1ef3: GHSA &lt; 130mg\/dL, gi\u00fap ki\u1ec3m so\u00e1t leucine, threonine, acid b\u00e9o t\u1ef1 do, t\u1ed5ng th\u1ec3 glucose huy\u1ebft v\u00e0 gi\u00fap gi\u1ea3m nguy c\u01a1 thai l\u1edbn.<\/p>\n<p>-Ba th\u00e1ng cu\u1ed1i thai k\u1ef3: GHSA &lt; 130mg\/dL gi\u00fap gi\u1ea3m nguy c\u01a1 h\u1ed9i ch\u1ee9ng suy ki\u1ec7t h\u00f4 h\u1ea5p, thai l\u01b0u, ki\u1ec3m so\u00e1t ceton m\u00e1u -Sau sinh: GHSA &lt; 180mg\/dL.<\/p>\n<p>\u0110\u1ed1i v\u1edbi type 1: c\u1ea7n \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c v\u1edbi nhi\u1ec1u m\u0169i ti\u00eam trong ng\u00e0y , v\u00ed d\u1ee5 3 m\u0169i insulin t\u00e1c d\u1ee5ng nhanh tr\u01b0\u1edbc 3 b\u1eefa \u0103n, 1 m\u0169i insulin ch\u1eadm l\u00fac 21 gi\u1edd. \u0110i\u1ec1u ch\u1ec9nh li\u1ec1u l\u01b0\u1ee3ng m\u1ed7i 1-2 tu\u1ea7n tu\u1ef3 nhu c\u1ea7u, l\u01b0u \u00fd g\u1ea7n cu\u1ed1i 3 th\u00e1ng \u0111\u1ea7u nhu c\u1ea7u insulin th\u01b0\u1eddng gi\u1ea3m, sau \u0111\u00f3 t\u0103ng d\u1ea7n l\u00ean v\u00e0o 3 th\u00e1ng cu\u1ed1i c\u00f3 th\u1ec3 \u0111\u1ebfn g\u1ea5p 3 l\u1ea7n li\u1ec1u l\u01b0\u1ee3ng d\u00f9ng tr\u01b0\u1edbc l\u00fac mang thai.<\/p>\n<p>C\u0169ng c\u00f3 th\u1ec3 ti\u00eam 2 m\u0169i\/ng\u00e0y lo\u1ea1i insulin h\u1ed7n h\u1ee3p: lo\u1ea1i 70% insulin NPH v\u00e0 30% insulin t\u00e1c d\u1ee5ng nhanh cho tr\u01b0\u1edbc \u0103n s\u00e1ng 2\/3 t\u1ed5ng li\u1ec1u c\u1ee7a ng\u00e0y, lo\u1ea1i 50% insulin NPH v\u00e0 50% insulin t\u00e1c d\u1ee5ng nhanh cho tr\u01b0\u1edbc \u0103n chi\u1ec1u 1\/3 t\u1ed5ng li\u1ec1u c\u1ee7a ng\u00e0y.<\/p>\n<p>\u0110\u1ed1i v\u1edbi type 2: c\u0169ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb v\u1edbi insulin.<\/p>\n<p>\u0110\u1ed1i v\u1edbi \u0110T\u0110TN: ch\u01b0a c\u00f3 1 chu\u1ea9n m\u1ef1c n\u00e0o th\u1ed1ng nh\u1ea5t, tuy nhi\u00ean \u0111a s\u1ed1\u00a0 \u0111\u1ed3ng \u00fd d\u00f9ng insulin ngay, khi glucose huy\u1ebft l\u00fac \u0111\u00f3i \u2265 126mg\/dL, ngay c\u1ea3 v\u1edbi glucose huy\u1ebft &gt;105mg\/dL v\u00e0 &lt; 126mg\/dL v\u1edbi 2 l\u1ea7n x\u00e9t nghi\u1ec7m c\u00e1ch bi\u1ec7t, c\u0169ng n\u00ean d\u00f9ng insulin sau khi ti\u1ebft th\u1ef1c th\u1ea5t b\u1ea1i.<\/p>\n<figure id=\"attachment_31593\" aria-describedby=\"caption-attachment-31593\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-31593\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Thiet-ke-chua-co-ten-31-300x300.png\" alt=\"\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng thai ngh\u00e9n\" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Thiet-ke-chua-co-ten-31-300x300.png 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Thiet-ke-chua-co-ten-31-1024x1024.png 1024w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Thiet-ke-chua-co-ten-31-150x150.png 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Thiet-ke-chua-co-ten-31-768x768.png 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Thiet-ke-chua-co-ten-31.png 1080w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-31593\" class=\"wp-caption-text\">\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng thai ngh\u00e9n<\/figcaption><\/figure>\n<p><strong>1.3 Trong khi chuy\u1ec3n d\u1ea1 v\u00e0 sau sinh<\/strong><\/p>\n<p>V\u1edbi \u0110T\u0110 n\u00f3i chung, m\u1ee5c ti\u00eau \u0111i\u1ec1u tr\u1ecb l\u00e0 duy tr\u00ec glucose \u1edf m\u1ee9c sinh l\u00fd (70-<\/p>\n<p>120mg\/dL). \u0110\u1ec3 tr\u00e1nh t\u0103ng glucose\u00a0 m\u00e1u, ng\u01b0\u1eddi b\u1ec7nh n\u00ean \u0111\u01a3\u1ee3c h\u1ea1n ch\u1ebf \u0103n u\u1ed1ng\u00a0 v\u00e0 truy\u1ec1n c\u00e1c d\u1ecbch kh\u00e1c. Truy\u1ec1n t\u0129nh m\u1ea1ch \u0111\u01b0\u1eddng dextrose t\u1ed1c \u0111\u1ed9 5-8g\/gi\u1edd, d\u00f9ng \u0111\u01b0\u1eddng 10% truy\u1ec1n 50-80ml\/gi\u1edd. T\u1ea5t c\u1ea3 nh\u1eefng d\u1ecbch truy\u1ec1n kh\u00e1c ph\u1ea3i kh\u00f4ng c\u00f3 glucose. Theo d\u00f5i glucose m\u1ed7i 1-4 gi\u1edd.<\/p>\n<p>Insulin \u0111\u01b0\u1ee3c cho theo nhu c\u1ea7u: ho\u1eb7c truy\u1ec1n t\u0129nh m\u1ea1ch li\u00ean t\u1ee5c (0,01-0,04\u0111v\/kg c\u01a1 th\u1ec3 hi\u1ec7n t\u1ea1i\/gi\u1edd), ho\u1eb7c b\u1eb1ng \u0111\u01b0\u1eddng ti\u00eam d\u01b0\u1edbi da lo\u1ea1i insulin nhanh m\u1ed7i 3-6 gi\u1edd.<\/p>\n<p>Nhu c\u1ea7u glucose, insulin \u0111i\u1ec1u ch\u1ec9nh theo k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m glucose huy\u1ebft t\u1eebng l\u00fac, th\u1eddi gian v\u00e0 \u0111\u01b0\u1eddng ti\u00eam cu\u1ed1i c\u00f9ng, v\u00e0 th\u1eddi gian c\u1ee7a l\u1ea7n cung c\u1ea5p n\u0103ng l\u01a3\u1ee3ng tr\u01a3\u1edbc l\u00fac sinh.<\/p>\n<p>T\u00e1c \u0111\u1ed9ng c\u1ee7a v\u1eadn \u0111\u1ed9ng\u00a0 th\u1ec3 l\u1ef1c trong l\u00fac sinh n\u1edf c\u00f3 th\u1ec3 l\u00e0m t\u0103ng s\u1ef1 ti\u00eau th\u1ee5 glucose, nh\u01b0ng c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh th\u00f4ng qua vi\u1ec7c g\u00e2y t\u00ea tu\u1ef7 s\u1ed1ng li\u00ean t\u1ee5c trong cu\u1ed9c sinh.<\/p>\n<p>V\u1edbi \u0110T\u0110TN th\u01a3\u1eddng kh\u00f4ng c\u1ea7n d\u00f9ng insulin trong l\u00fac sinh, ngay c\u1ea3 \u0111\u1ed1i v\u1edbi m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u0110T\u0110 t\u00fdp 2 nh\u1eb9 c\u0169ng v\u1eady.<\/p>\n<p>Nhu c\u1ea7u insulin gi\u1ea3m nhanh ch\u00f3ng\u00a0 ngay sau khi sinh( c\u00f3 th\u1ec3 gi\u1ea3m \u0111\u1ebfn 5090%) do \u0111\u00f3 li\u1ec1u insulin\/ng\u00e0y c\u1ea7n gi\u1ea3m xu\u1ed1ng ch\u1ec9 c n kho\u1ea3ng 30% ho\u1eb7c gi\u1ea3m h\u01a1n n\u1eefa so v\u1edbi li\u1ec1u tr\u01b0\u1edbc l\u00fac sinh\u2026N\u1ebfu nhu c\u1ea7u insulin v\u1eabn cao sau sinh c\u00f3 th\u1ec3\u00a0 l\u00e0 d\u1ea5u hi\u1ec7u c\u1ee7a nhi\u1ec5m tr\u00f9ng h\u1eadu s\u1ea3n.<\/p>\n<p>Insulin TM tr\u01b0\u1edbc \u0111\u00f3 s\u1ebd nhanh ch\u00f3ng h\u1ebft t\u00e1c d\u1ee5ng, n\u00ean chuy\u1ec3n\u00a0 t\u1eeb TM qua \u0111\u01b0\u1eddng d\u01b0\u1edbi da ngay sau khi sinh, th\u01b0\u1eddng th\u00ec nhu c\u1ea7u insulin nhanh ch\u00f3ng tr\u1edf l\u1ea1i nh\u01b0 tr\u01b0\u1edbc khi sinh.<\/p>\n<p>S\u1ea3n ph\u1ee5 \u0110T\u0110 ph\u1ee5 thu\u1ed9c insulin nh\u1eefng ng\u00e0y \u0111\u1ea7u sau sinh th\u01b0\u1eddng ch\u1ec9 c\u1ea7n li\u1ec1u nh\u1ecf th\u1eadm ch\u00ed kh\u00f4ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb insulin<\/p>\n<p><strong>1.4C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1c<\/strong><\/p>\n<p>T\u1eadp th\u1ec3 d\u1ee5c \u1edf thai ph\u1ee5 c\u1ea7n th\u1eadn tr\u1ecdng v\u00ec c\u00f3 th\u1ec3 g\u00e2y co th\u1eaft t\u1eed cung, sinh non, tim thai ch\u1eadm, nh\u1ea5t l\u00e0 \u1edf nh\u1eefng thai ph\u1ee5 tr\u01b0\u1edbc \u0111\u00e2y kh\u00f4ng h\u1ec1 t\u1eadp luy\u1ec7n. D\u1eabu sao th\u1ec3 d\u1ee5c nh\u1eb9 nh\u00e0ng nh\u01b0 \u0111i xe \u0111\u1ea1p t\u1ecf ra an to\u00e0n v\u00e0 h\u1eefu \u00edch.<\/p>\n<h2><strong>2. Bi\u1ebfn ch\u1ee9ng\u00a0<\/strong><\/h2>\n<p><strong>2.1 Cho con\u00a0<\/strong><\/p>\n<ul>\n<li>S\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a thai \u1edf nh\u1eefng ng\u01a3\u1eddi m\u1eb9 \u0110T\u0110 n\u00f3i chung c\u00f3 th\u1ec3 c\u00f3 nh\u1eefng d\u1ecb t\u1eadt \u1ea3nh h\u01a3\u1edfng l\u1edbn \u0111\u1ebfn t\u01a3\u01a1ng lai c\u1ee7a tr\u1ebb:<\/li>\n<\/ul>\n<p>+\u00a0 T\u1ed5n \u1ed1ng th\u1ea7n kinh<\/p>\n<p>+\u00a0 D\u1ecb t\u1eadt b\u1ea9m sinh \u1edf tim v\u00e0 m\u1ed9t s\u1ed1 th\u01a3\u01a1ng t\u1ed5n kh\u00e1c.<\/p>\n<ul>\n<li>Thai qu\u00e1 ph\u00e1t tri\u1ec3n do t\u0103ng t\u00edch ch\u1ee9a m\u1ee1, gia t\u0103ng chi\u1ec1u d\u00e0i, gia t\u0103ng t\u1ef7 l\u1ec7 b\u1ee5ng\/\u0111\u1ea7u ho\u1eb7c ng\u1ef1c\/\u0111\u1ea7u<\/li>\n<li>Thai k\u00e9m ph\u00e1t tri\u1ec3n c\u00f3 th\u1ec3 g\u00e2y nhi\u1ec1u bi\u1ebfn ch\u1ee9ng t\u00e1c h\u1ea1i kh\u00e1c cho thai.<\/li>\n<li>\u0110a \u1ed1i, \u0111a \u1ed1i th\u01a3\u1eddng \u0111i li\u1ec1n v\u1edbi thai to, g\u00e2y kh\u00f3 ch\u1ecbu v\u00e0 g\u00e2y sinh non<\/li>\n<li>M\u1ed9t s\u1ed1 nguy c\u01a1 kh\u00e1c cho thai nhi c\u00f3 th\u1ec3 g\u1eb7p do t\u0103ng insulin nh\u01a3: h\u1ed9i ch\u1ee9ng suy h\u00f4 h\u1ea5p, h\u1ea1 glucose huy\u1ebft, t\u0103ng billirubin m\u00e1u, h\u1ea1 calci m\u00e1u, k\u00e9m \u0103n.<\/li>\n<\/ul>\n<p><strong>2.2 Cho m\u1eb9\u00a0<\/strong><\/p>\n<ul>\n<li>Ph\u1ee5 n\u1eef c\u00f3 bi\u1ebfn ch\u1ee9ng tim m\u1ea1ch v\u00e0\/ho\u1eb7c \u0110T\u0110 l\u00e0 nguy c\u01a1 l\u1edbn v\u1ec1 b\u1ec7nh t\u1eadt v\u00e0 t\u1eed vong trong su\u1ed1t qu\u00e1 tr\u00ecnh mang thai.<\/li>\n<li>Nhi\u1ec1u bi\u1ebfn ch\u1ee9ng b\u1ec7nh t\u1eadt do \u0110T\u0110 \u1edf ph\u1ee5 n\u1eef mang thai tr\u1edf l\u1ea1i g\u00f3p ph\u1ea7n l\u00e0m r\u1ed1i lo\u1ea1n th\u00eam chuy\u1ec3n ho\u00e1 t\u1eeb \u0111\u00f3 t\u00e1c \u0111\u1ed9ng x\u1ea5u l\u00ean s\u1ef1 ki\u1ec3m so\u00e1t glucose huy\u1ebft.<\/li>\n<li>Nhi\u1ec5m toan ceton th\u01b0\u1eddng x\u1ea3y ra v\u00e0o 6 th\u00e1ng sau c\u1ee7a thai k\u1ef3, \u0111\u00e2y l\u00e0 giai \u0111o\u1ea1n s\u1ef1 mang thai c\u00f3 t\u00e1c \u0111\u1ed9ng m\u1ea1nh nh\u1ea5t l\u00ean \u0110T\u0110. Nhi\u1ec5m toan ceton l\u00e0 m\u1ed9t nguy c\u01a1 g\u00e2y t\u1eed vong cho m\u1eb9 c\u0169ng nh\u01b0 t\u1eed vong chu sinh cho thai nhi.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng thai ngh\u00e9n (\u0110TNTN) l\u00e0 s\u1ef1 gi\u1ea3m dung n\u1ea1p glucose ho\u1eb7c \u0110T\u0110 (\u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng) \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n l\u1ea7n \u0111\u1ea7u trong l\u00fac mang thai (kh\u00f4ng lo\u1ea1i tr\u1eeb ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e3 c\u00f3 gi\u1ea3m dung n\u1ea1p glucose ho\u1eb7c \u0110T\u0110 t\u1eeb tr\u01b0\u1edbc nh\u01b0ng ch\u01b0a \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n).\u00a0 1. \u0110i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng v\u00e0 thai nghen [&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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