{"id":32895,"date":"2023-05-10T14:10:58","date_gmt":"2023-05-10T07:10:58","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=32895"},"modified":"2023-05-10T14:10:58","modified_gmt":"2023-05-10T07:10:58","slug":"tang-huyet-ap-tren-phu-nu-co-thai-va-dieu-tri","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/10\/tang-huyet-ap-tren-phu-nu-co-thai-va-dieu-tri\/","title":{"rendered":"\u0110i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p tr\u00ean ph\u1ee5 n\u1eef c\u00f3 thai"},"content":{"rendered":"

\u0110i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p kh\u00f4ng d\u00f9ng thu\u1ed1c n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef mang thai b\u1ecb t\u0103ng huy\u1ebft \u00e1p, tuy nhi\u00ean c\u00e1c nghi\u00ean c\u1ee9u ch\u1ec9 ra r\u1eb1ng bi\u1ec7n ph\u00e1p n\u00e0y c\u00f3 hi\u1ec7u qu\u1ea3 th\u1ea5p trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p thai k\u1ef3. <\/strong><\/p>\n

\"T\u0103ng<\/p>\n

T\u0103ng huy\u1ebft \u00e1p \u1edf ph\u1ee5 n\u1eef c\u00f3 thai<\/strong><\/p>\n

1.\u0110\u1ecbnh ngh\u0129a<\/h2>\n

\u0110\u1ecbnh ngh\u0129a t\u0103ng huy\u1ebft \u00e1p \u1edf ph\u1ee5 n\u1eef c\u00f3 thai ch\u1ec9 d\u1ef1a v\u00e0o ch\u1ec9 s\u1ed1 huy\u1ebft \u00e1p \u0111o t\u1ea1i b\u1ec7nh vi\u1ec7n (ho\u1eb7c ph\u00f2ng kh\u00e1m) v\u1edbi huy\u1ebft \u00e1p t\u00e2m thu \u2265 140 mmHg v\u00e0\/ho\u1eb7c huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng \u2265 90 mmHg.<\/p>\n

T\u0103ng huy\u1ebft \u00e1p nh\u1eb9 khi huy\u1ebft \u00e1p t\u00e2m thu t\u1eeb 140 – 159 mmHg v\u00e0\/ho\u1eb7c huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng t\u1eeb 90 – 109 mmHg.<\/p>\n

T\u0103ng huy\u1ebft \u00e1p n\u1eb7ng khi huy\u1ebft \u00e1p t\u00e2m thu \u2265 160 mmHg v\u00e0\/ho\u1eb7c huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng \u2265 110 mmHg.<\/p>\n

Ph\u00e2n lo\u1ea1i t\u0103ng huy\u1ebft \u00e1p \u1edf ph\u1ee5 n\u1eef c\u00f3 thai g\u1ed3m 4 lo\u1ea1i nh\u01b0 sau:<\/p>\n

T\u0103ng huy\u1ebft \u00e1p c\u00f3 t\u1eeb tr\u01b0\u1edbc <\/strong>: Huy\u1ebft \u00e1p \u2265 140\/90 mmHg t\u1eeb tr\u01b0\u1edbc khi mang thai ho\u1eb7c ch\u1ea9n \u0111o\u00e1n tr\u01b0\u1edbc tu\u1ea7n 20 c\u1ee7a thai k\u1ef3, th\u01b0\u1eddng k\u00e9o d\u00e0i qu\u00e1 42 ng\u00e0y sau \u0111\u1ebb v\u00e0 c\u00f3 th\u1ec3 k\u00e8m theo protein ni\u1ec7u. T\u1ef7 l\u1ec7 g\u1eb7p kho\u1ea3ng 1 – 5%.<\/p>\n

T\u0103ng huy\u1ebft \u00e1p thai ngh\u00e9n <\/strong>: T\u0103ng huy\u1ebft \u00e1p xu\u1ea5t hi\u1ec7n sau tu\u1ea7n th\u1ee9 20 c\u1ee7a thai k\u1ef3, c\u00f3 th\u1ec3 k\u00e8m ho\u1eb7c kh\u00f4ng k\u00e8m protein ni\u1ec7u nh\u01b0ng kh\u00f4ng k\u00e8m c\u00e1c d\u1ea5u hi\u1ec7u ho\u1eb7c tri\u1ec7u ch\u1ee9ng c\u1ee7a ti\u1ec1n s\u1ea3n gi\u1eadt v\u00e0 th\u01b0\u1eddng h\u1ebft trong v\u00f2ng 42 ng\u00e0y sau khi sinh. T\u1ef7 l\u1ec7 g\u1eb7p t\u1eeb 6 – 7%.<\/p>\n

    \n
  • Ti\u1ec1n s\u1ea3n gi\u1eadt:<\/strong><\/li>\n<\/ul>\n

    Xu\u1ea5t hi\u1ec7n sau tu\u1ea7n th\u1ee9 20 c\u1ee7a thai k\u1ef3 k\u00e8m theo protein ni\u1ec7u 24 gi\u1edd > 300 mg ho\u1eb7c t\u1ef7 s\u1ed1 protein ni\u1ec7u\/creatinin ni\u1ec7u \u2265 30 mg\/mmol.<\/p>\n

    N\u1ebfu kh\u00f4ng c\u00f3 protein ni\u1ec7u, ti\u1ec1n s\u1ea3n gi\u1eadt \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a khi t\u0103ng huy\u1ebft \u00e1p m\u1edbi m\u1eafc k\u00e8m m\u1ed9t trong nh\u1eefng \u0111\u1eb7c \u0111i\u1ec3m sau: s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u gi\u1ea3m < 100.000\/^L, n\u1ed3ng \u0111\u1ed9 creatimn m\u00e1u > 1,1 mg\/dL, ho\u1eb7c g\u1ea5p \u0111\u00f4i n\u1ed3ng \u0111\u1ed9 creatinin \u1edf ng\u01b0\u1eddi kh\u00f4ng c\u00f3 b\u1ec7nh th\u1eadn kh\u00e1c, n\u1ed3ng \u0111\u1ed9 men gan t\u0103ng g\u1ea5p \u0111\u00f4i, ph\u00f9 ph\u1ed5i c\u1ea5p, c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u th\u1ea7n kinh ho\u1eb7c th\u1ecb gi\u00e1c. T\u1ef7 l\u1ec7 g\u1eb7p 2 – 5%\u00a0c\u00f3 t\u1eeb tr\u01b0\u1edbc l\u00e0m t\u0103ng n\u1eb7ng th\u00eam t\u00ecnh tr\u1ea1ng c\u1ee7a t\u0103ng huy\u1ebft \u00e1p thai k\u1ef3 c\u00f3 protein ni\u1ec7u.<\/p>\n

    T\u0103ng huy\u1ebft \u00e1p kh\u00f4ng ph\u00e2n lo\u1ea1i tr\u01b0\u1edbc sinh <\/strong>: Thu\u1eadt ng\u1eef n\u00e0y \u0111\u01b0\u1ee3c d\u00f9ng khi huy\u1ebft \u00e1p \u0111\u01b0\u1ee3c \u0111o l\u1ea7n \u0111\u1ea7u ti\u00ean sau tu\u1ea7n th\u1ee9 20 c\u1ee7a thai k\u1ef3 v\u00e0 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n l\u00e0 t\u0103ng huy\u1ebft \u00e1p. Vi\u1ec7c \u0111\u00e1nh gi\u00e1 l\u1ea1i sau 42 ng\u00e0y sau sinh l\u00e0 c\u1ea7n thi\u1ebft \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n.<\/p>\n

    2. \u0110i\u1ec1u tr\u1ecb<\/h2>\n

    2.1 \u0110i\u1ec1u tr\u1ecb kh\u00f4ng d\u00f9ng thu\u1ed1c<\/strong><\/h3>\n

    \u0110i\u1ec1u tr\u1ecb kh\u00f4ng d\u00f9ng thu\u1ed1c n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef mang thai b\u1ecb t\u0103ng huy\u1ebft \u00e1p, tuy nhi\u00ean c\u00e1c nghi\u00ean c\u1ee9u ch\u1ec9 ra r\u1eb1ng bi\u1ec7n ph\u00e1p n\u00e0y c\u00f3 hi\u1ec7u qu\u1ea3 th\u1ea5p trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p thai k\u1ef3. C\u00e1c bi\u1ec7n ph\u00e1p g\u1ed3m:<\/p>\n

      \n
    • H\u1ea1n ch\u1ebf ho\u1ea1t \u0111\u1ed9ng th\u1ec3 l\u1ef1c<\/li>\n
    • Ch\u1ebf \u0111\u1ed9 \u0103n b\u00ecnh th\u01b0\u1eddng kh\u00f4ng c\u1ea7n h\u1ea1n ch\u1ebf mu\u1ed1i \u0111\u1eb7c bi\u1ec7t khi s\u1ea3n ph\u1ee5 s\u1eafp sinh v\u00ec \u0103n gi\u1ea3m mu\u1ed1i c\u00f3 th\u1ec3 g\u00e2y gi\u1ea3m th\u1ec3 t\u00edch trong l\u00f2ng m\u1ea1ch. Cung c\u1ea5p \u00edt nh\u1ea5t 1g canxi h\u00e0ng ng\u00e0y gi\u00fap gi\u1ea3m nguy c\u01a1 ti\u1ec1n s\u1ea3n gi\u1eadt.<\/li>\n
    • D\u1ea7u c\u00e1, vitamin kh\u00f4ng c\u00f3 vai tr\u00f2 trong ph\u00f2ng ng\u1eeba t\u0103ng huy\u1ebft \u00e1p \u1edf ph\u1ee5 n\u1eef c\u00f3 thai.<\/li>\n
    • Kh\u00f4ng khuy\u1ebfn c\u00e1o gi\u1ea3m c\u00e2n trong khi mang thai k\u1ec3 c\u1ea3 \u1edf ng\u01b0\u1eddi b\u00e9o ph\u00ec v\u00ec c\u00f3 th\u1ec3 g\u00e2y gi\u1ea3m c\u00e2n n\u1eb7ng \u1edf thai nhi v\u00e0 ch\u1eadm ph\u00e1t tri\u1ec3n \u1edf tr\u1ebb sau n\u00e0y.<\/li>\n
    • Ph\u1ee5 n\u1eef b\u00e9o ph\u00ec (BMI \u2265 30 kg\/m2) \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o tr\u00e1nh t\u0103ng qu\u00e1 6,8 kg c\u00e2n n\u1eb7ng trong thai k\u1ef3.<\/li>\n<\/ul>\n

      2.2 \u0110i\u1ec1u tr\u1ecb d\u00f9ng thu\u1ed1c<\/h3>\n

      2.2.1 \u0110i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p m\u1ee9c \u0111\u1ed9 nh\u1eb9 (huy\u1ebft \u00e1p 140-159\/90-109 mmHg)<\/h4>\n

      M\u1ee5c \u0111\u00edch \u0111i\u1ec1u tr\u1ecb l\u00e0m gi\u1ea3m bi\u1ebfn c\u1ed1 cho m\u1eb9 nh\u01b0ng c\u00e1c thu\u1ed1c s\u1eed d\u1ee5ng ph\u1ea3i an to\u00e0n v\u1edbi thai nhi. Tuy nhi\u00ean l\u1ee3i \u00edch cho m\u1eb9 v\u00e0 thai nhi c\u1ee7a c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p kh\u00f4ng \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u r\u1ed9ng r\u00e3i. Alpha-methyldopa l\u00e0 thu\u1ed1c c\u00f3 c\u00e1c b\u1eb1ng ch\u1ee9ng t\u1ed1t nh\u1ea5t t\u1eeb m\u1ed9t th\u1eed nghi\u1ec7m c\u00e1ch \u0111\u00e2y h\u01a1n 40 n\u0103m.<\/p>\n

      M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y cho th\u1ea5y kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 nguy c\u01a1 c\u00e1c bi\u1ebfn ch\u1ee9ng n\u1eb7ng \u1edf ng\u01b0\u1eddi m\u1eb9 gi\u1eefa ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p ch\u1eb7t ch\u1ebd so v\u1edbi kh\u00f4ng ch\u1eb7t ch\u1ebd \u1edf ph\u1ee5 n\u1eef c\u00f3 thai. Tuy nhi\u00ean, c\u00e1c ph\u00e2n t\u00edch s\u00e2u h\u01a1n g\u1ee3i \u00fd ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p ch\u1eb7t ch\u1ebd s\u1ebd l\u00e0m gi\u1ea3m t\u0103ng huy\u1ebft \u00e1p ti\u1ebfn tri\u1ec3n n\u1eb7ng v\u00e0 ti\u1ec1n s\u1ea3n gi\u1eadt.<\/p>\n

      Kh\u00f4ng c\u00f3 d\u1eef li\u1ec7u \u0111\u1ecbnh ngh\u0129a v\u1ec1 \u0111\u00edch \u0111i\u1ec1u tr\u1ecb huy\u1ebft \u00e1p t\u1ed1i \u01b0u \u1edf ph\u1ee5 n\u1eef mang thai. Tuy nhi\u00ean, n\u00ean duy tr\u00ec huy\u1ebft \u00e1p m\u1ee5c ti\u00eau < 140\/90 mmHg \u1edf ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u00f3 thai t\u0103ng huy\u1ebft \u00e1p \u0111ang \u0111i\u1ec1u tr\u1ecb thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p.<\/p>\n

      Khuy\u1ebfn c\u00e1o c\u1ee7a H\u1ed9i Tim m\u1ea1ch Ch\u00e2u \u00c2u 2018 kh\u1edfi \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb khi:<\/p>\n

      T\u1ea5t c\u1ea3 ph\u1ee5 n\u1eef mang thai c\u00f3 huy\u1ebft \u00e1p \u2265 150\/95 mmHg k\u00e9o d\u00e0i ho\u1eb7c > 140\/90 mmHg \u1edf b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n t\u0103ng huy\u1ebft \u00e1p thai k\u1ef3 k\u00e8m ho\u1eb7c kh\u00f4ng k\u00e8m protein ni\u1ec7u; t\u0103ng huy\u1ebft \u00e1p c\u00f3 t\u1eeb tr\u01b0\u1edbc l\u00e0m n\u1eb7ng th\u00eam t\u0103ng huy\u1ebft \u00e1p thai k\u1ef3; t\u0103ng huy\u1ebft \u00e1p c\u00f3 tri\u1ec7u ch\u1ee9ng ho\u1eb7c k\u00e8m t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan \u0111\u00edch d\u01b0\u1edbi l\u00e2m s\u00e0ng \u1edf b\u1ea5t k\u1ef3 th\u1eddi \u0111i\u1ec3m n\u00e0o c\u1ee7a thai k\u1ef3.<\/p>\n

      2.2.2 \u0110i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p m\u1ee9c \u0111\u1ed9 n\u1eb7ng (\u2265 160\/110 mmHg)<\/h4>\n

      H\u1ed9i tim m\u1ea1ch Ch\u00e2u \u00c2u coi huy\u1ebft \u00e1p \u2265 170\/110 mmHg l\u00e0 c\u1ea5p c\u1ee9u \u1edf ph\u1ee5 n\u1eef c\u00f3 thai, nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y n\u00ean \u0111\u01b0\u1ee3c nh\u1eadp vi\u1ec7n ngay. \u0110i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 kh\u1edfi \u0111\u1ea7u b\u1eb1ng c\u00e1c thu\u1ed1c nh\u01b0 labetalol \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch, methyldopa u\u1ed1ng ho\u1eb7c thu\u1ed1c ch\u1eb9n k\u00eanh canxi, nitroglycerin truy\u1ec1n t\u0129nh m\u1ea1ch trong tr\u01b0\u1eddng h\u1ee3p t\u0103ng huy\u1ebft \u00e1p n\u1eb7ng c\u00f3 ph\u00f9 ph\u1ed5i.<\/p>\n

      Trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n t\u0103ng huy\u1ebft \u00e1p c\u01a1n c\u00f3 s\u1ea3n gi\u1eadt ho\u1eb7c s\u1ea3n gi\u1eadt n\u1eb7ng (k\u00e8m ho\u1eb7c kh\u00f4ng k\u00e8m xu\u1ea5t huy\u1ebft, t\u0103ng men gan v\u00e0 gi\u1ea3m ti\u1ec3u c\u1ea7u), b\u1ec7nh nh\u00e2n c\u1ea7n ph\u1ea3i nh\u1eadp vi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p, khi t\u00ecnh tr\u1ea1ng ng\u01b0\u1eddi m\u1eb9 \u1ed5n \u0111\u1ecbnh c\u1ea7n c\u00e2n nh\u1eafc \u0111\u00ecnh ch\u1ec9 thai ngh\u00e9n. Truy\u1ec1n t\u0129nh m\u1ea1ch magie sulfate \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u0111\u1ec3 d\u1ef1 ph\u00f2ng s\u1ea3n gi\u1eadt.<\/p>\n

      C\u00e1c chuy\u00ean gia \u0111\u01b0a ra \u0111\u1ed3ng thu\u1eadn n\u00ean h\u1ea1 huy\u1ebft \u00e1p < 160\/105 mmHg \u0111\u1ec3 ph\u00f2ng ng\u1eeba bi\u1ebfn ch\u1ee9ng t\u0103ng huy\u1ebft \u00e1p c\u1ea5p t\u00ednh \u1edf ng\u01b0\u1eddi m\u1eb9. Labetalol v\u00e0 nicardipin \u0111\u01b0\u1ee3c ch\u1ee9ng minh an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 trong \u0111i\u1ec1u tr\u1ecb ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng.<\/p>\n

      Trong tr\u01b0\u1eddng h\u1ee3p c\u00f3 ph\u00f9 ph\u1ed5i c\u1ea5p, c\u1ea7n truy\u1ec1n nitroglycerin t\u0129nh m\u1ea1ch v\u1edbi li\u1ec1u kh\u1edfi \u0111\u1ea7u 5 pg\/min v\u00e0 t\u0103ng d\u1ea7n li\u1ec1u m\u1ed7i 3 – 5 ph\u00fat cho t\u1edbi khi li\u1ec1u t\u1ed1i \u0111a 100 Iig\/min.<\/p>\n

      Ch\u1ec9 \u0111\u1ecbnh \u0111\u00ecnh ch\u1ec9 thai ngh\u00e9n <\/strong>khi: Ti\u1ec1n s\u1ea3n gi\u1eadt k\u00e8m r\u1ed1i lo\u1ea1n th\u1ecb gi\u00e1c ho\u1eb7c xu\u1ea5t huy\u1ebft ho\u1eb7c khi thai 37 tu\u1ea7n d\u00f9 kh\u00f4ng tri\u1ec7u ch\u1ee9ng.<\/p>\n

      2.2.3 Khuy\u1ebfn c\u00e1o c\u1ee7a H\u1ed9i tim m\u1ea1ch ch\u00e2u \u00c2u (ESC 2018) v\u1ec1 \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p \u1edf ph\u1ee5 n\u1eef c\u00f3 thai<\/strong><\/h4>\n
        \n
      • Khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng aspirin 100 – 150 mg\/ng\u00e0y \u1edf ph\u1ee5 n\u1eef c\u00f3 nguy c\u01a1 cao ho\u1eb7c nguy c\u01a1 trung b\u00ecnh m\u1eafc ti\u1ec1n s\u1ea3n gi\u1eadt t\u1eeb tu\u1ea7n thai 12 \u0111\u1ebfn tu\u1ea7n thai 36 – 37 (I-A).<\/li>\n
      • Ng\u01b0\u1eddi b\u1ecb t\u0103ng huy\u1ebft \u00e1p thai k\u1ef3, t\u0103ng huy\u1ebft \u00e1p m\u1ea1n t\u00ednh ho\u1eb7c t\u0103ng huy\u1ebft \u00e1p k\u00e8m t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan \u0111\u00edch d\u01b0\u1edbi l\u00e2m s\u00e0ng n\u00ean kh\u1edfi \u0111\u1ea7u thu\u1ed1c \u0111i\u1ec1u tr\u1ecb khi huy\u1ebft \u00e1p t\u00e2m thu > 140 mmHg ho\u1eb7c huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng > 90 mmHg (I-C).<\/li>\n
      • Trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p c\u00f2n l\u1ea1i, n\u00ean kh\u1edfi \u0111\u1ea7u thu\u1ed1c huy\u1ebft \u00e1p khi huy\u1ebft \u00e1p t\u00e2m thu \u2265 150 mmHg ho\u1eb7c huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng \u2265 95 mmHg (I-C).<\/li>\n
      • Methyldopa (I-B), labetalol v\u00e0 thu\u1ed1c ch\u1eb9n k\u00eanh canxi (I-C) \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o l\u1ef1a ch\u1ecdn trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p \u1edf ph\u1ee5 n\u1eef c\u00f3 thai.<\/li>\n
      • Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n, thu\u1ed1c \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 ho\u1eb7c thu\u1ed1c \u1ee9c ch\u1ebf renin tr\u1ef1c ti\u1ebfp \u1edf ph\u1ee5 n\u1eef mang thai (III-C).<\/li>\n
      • Huy\u1ebft \u00e1p t\u00e2m thu \u2265 170 mmHg ho\u1eb7c huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng \u2265 110 mmHg \u1edf ph\u1ee5 n\u1eef c\u00f3 thai l\u00e0 t\u00ecnh tr\u1ea1ng c\u1ea5p c\u1ee9u c\u1ea7n ph\u1ea3i nh\u1eadp vi\u1ec7n (I-C).<\/li>\n
      • Trong tr\u01b0\u1eddng h\u1ee3p t\u0103ng huy\u1ebft \u00e1p n\u1eb7ng, thu\u1ed1c \u0111i\u1ec1u tr\u1ecb n\u00ean s\u1eed d\u1ee5ng l\u00e0 labetalol \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch, methyldopa \u0111\u01b0\u1eddng u\u1ed1ng ho\u1eb7c nifedipin (I-C).<\/li>\n
      • Khuy\u1ebfn c\u00e1o \u0111i\u1ec1u tr\u1ecb c\u01a1n t\u0103ng huy\u1ebft \u00e1p b\u1eb1ng labetalol t\u0129nh m\u1ea1ch ho\u1eb7c nicardipine t\u0129nh m\u1ea1ch k\u00e8m magie sulfate (I-C).<\/li>\n
      • Ti\u1ec1n s\u1ea3n gi\u1eadt k\u00e8m ph\u00f9 ph\u1ed5i c\u1ea5p n\u00ean \u0111\u01b0\u1ee3c x\u1eed tr\u00ed b\u1eb1ng truy\u1ec1n t\u0129nh m\u1ea1ch nitroglycerin (I-C).<\/li>\n
      • \u1ede ph\u1ee5 n\u1eef t\u0103ng huy\u1ebft \u00e1p thai k\u1ef3 ho\u1eb7c ti\u1ec1n s\u1ea3n gi\u1eadt, n\u00ean \u0111\u00ecnh ch\u1ec9 thai ngh\u00e9n \u1edf tu\u1ea7n thai 37 (I-B).<\/li>\n
      • N\u00ean \u0111\u00ecnh ch\u1ec9 thai ngh\u00e9n \u1edf b\u1ec7nh nh\u00e2n ti\u1ec1n s\u1ea3n gi\u1eadt k\u00e8m theo c\u00e1c t\u00ecnh tr\u1ea1ng n\u1eb7ng nh\u01b0 r\u1ed1i lo\u1ea1n th\u1ecb gi\u00e1c ho\u1eb7c ch\u1ea3y m\u00e1u (I-C).<\/li>\n
      • Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n, thu\u1ed1c \u1ee9c ch\u1ebf th\u1ee5 th\u1ec3 ho\u1eb7c thu\u1ed1c \u1ee9c ch\u1ebf tr\u1ef1c ti\u1ebfp renin (III-C).<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

        \u0110i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p kh\u00f4ng d\u00f9ng thu\u1ed1c n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef mang thai b\u1ecb t\u0103ng huy\u1ebft \u00e1p, tuy nhi\u00ean c\u00e1c nghi\u00ean c\u1ee9u ch\u1ec9 ra r\u1eb1ng bi\u1ec7n ph\u00e1p n\u00e0y c\u00f3 hi\u1ec7u qu\u1ea3 th\u1ea5p trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p thai k\u1ef3. T\u0103ng huy\u1ebft \u00e1p \u1edf ph\u1ee5 n\u1eef c\u00f3 thai 1.\u0110\u1ecbnh ngh\u0129a \u0110\u1ecbnh […]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"\n\u0110i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p tr\u00ean ph\u1ee5 n\u1eef c\u00f3 thai - Vinmec<\/title>\n<meta name=\"description\" content=\"\u0110i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p kh\u00f4ng d\u00f9ng thu\u1ed1c n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef mang thai b\u1ecb t\u0103ng huy\u1ebft \u00e1p. 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