{"id":35603,"date":"2023-06-25T22:37:59","date_gmt":"2023-06-25T15:37:59","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=35603"},"modified":"2023-06-25T22:37:59","modified_gmt":"2023-06-25T15:37:59","slug":"tang-huyet-ap-thai-ky-cac-bieu-hien-va-cach-dieu-tri-an-toan-cho-me-va-thai-nhi","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/06\/25\/tang-huyet-ap-thai-ky-cac-bieu-hien-va-cach-dieu-tri-an-toan-cho-me-va-thai-nhi\/","title":{"rendered":"T\u0103ng huy\u1ebft \u00e1p thai k\u1ef3: C\u00e1c bi\u1ec3u hi\u1ec7n v\u00e0 c\u00e1ch \u0111i\u1ec1u tr\u1ecb an to\u00e0n cho m\u1eb9 v\u00e0 thai nhi"},"content":{"rendered":"<p><strong>T\u0103ng huy\u1ebft \u00e1p thai k\u1ef3 l\u00e0 m\u1ed9t nh\u00f3m l\u1edbn c\u00e1c b\u1ec7nh l\u00fd v\u1edbi b\u1ec7nh sinh kh\u00f4ng thu\u1ea7n nh\u1ea5t, \u0111\u00f2i h\u1ecfi c\u00e1c k\u1ebf ho\u1ea1ch qu\u1ea3n l\u00fd kh\u00e1c nhau. Nh\u1eadn di\u1ec7n, ph\u00e2n lo\u1ea1i c\u00e1c b\u1ec7nh l\u00fd t\u0103ng huy\u1ebft \u00e1p trong thai k\u1ef3 l\u00e0 m\u1ed9t b\u01b0\u1edbc quan tr\u1ecdng tr\u01b0\u1edbc khi \u0111\u1ec1 ra m\u1ed9t ph\u01b0\u01a1ng th\u1ee9c qu\u1ea3n l\u00fd th\u00edch h\u1ee3p. Ti\u1ec1n s\u1ea3n gi\u1eadt l\u00e0 m\u1ed9t h\u1ed9i ch\u1ee9ng bao g\u1ed3m t\u0103ng huy\u1ebft \u00e1p c\u00f3 k\u00e8m \u0111\u1ea1m ni\u1ec7u xu\u1ea5t hi\u1ec7n sau tu\u1ea7n th\u1ee9 20 c\u1ee7a thai k\u1ef3.<\/strong><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone wp-image-35604 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/b64e6da8-9995-4f54-a265-92e1eda93f49-300x300.jpg\" alt=\"tang-huyet-ap-thai-ky\" width=\"300\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/b64e6da8-9995-4f54-a265-92e1eda93f49-300x300.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/b64e6da8-9995-4f54-a265-92e1eda93f49-150x150.jpg 150w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/b64e6da8-9995-4f54-a265-92e1eda93f49-768x768.jpg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/b64e6da8-9995-4f54-a265-92e1eda93f49.jpg 1024w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<h2><strong>1. C\u00e1c bi\u1ec3u hi\u1ec7n r\u1ed1i lo\u1ea1n cao huy\u1ebft \u00e1p trong thai k\u1ef3.<\/strong><\/h2>\n<p>Theo ACOG 2014, ta c\u00f3 \u0111\u1ecbnh ngh\u0129a 5 nh\u00f3m r\u1ed1i lo\u1ea1n cao huy\u1ebft \u00e1p (HA) trong thai k\u1ef3:<\/p>\n<p><strong>&#8211; Ti\u1ec1n s\u1ea3n gi\u1eadt:<\/strong><\/p>\n<p>Ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n ti\u1ec1n s\u1ea3n gi\u1eadt:<\/p>\n<p>+ <strong>Huy\u1ebft \u00e1p<\/strong>:<\/p>\n<ul>\n<li>HA t\u00e2m thu \u2265 140 mmHg ho\u1eb7c HA t\u00e2m tr\u01b0\u01a1ng \u2265 90 mmHg trong hai l\u1ea7n \u0111o \u00edt nh\u1ea5t c\u00e1ch 4 gi\u1edd, \u1edf thai sau 20 tu\u1ea7n tu\u1ed5i tr\u00ean ph\u1ee5 n\u1eef c\u00f3 HA b\u00ecnh th\u01b0\u1eddng tr\u01b0\u1edbc \u0111\u00f3.<\/li>\n<li>HA t\u00e2m thu \u2265 160 mmHg ho\u1eb7c HA t\u00e2m tr\u01b0\u01a1ng \u2265 110 mmHg, t\u0103ng HA c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c x\u00e1c nh\u1eadn trong m\u1ed9t kho\u1ea3ng th\u1eddi gian ng\u1eafn (15 ph\u00fat) \u0111\u1ec3 t\u1ea1o \u0111i\u1ec1u ki\u1ec7n \u0111i\u1ec1u tr\u1ecb h\u1ea1 \u00e1p k\u1ecbp th\u1eddi.<\/li>\n<\/ul>\n<p>+ V\u00e0 <strong>Protein ni\u1ec7u<\/strong>:<\/p>\n<ul>\n<li>\u2265 300 mg\/24 gi\u1edd.<\/li>\n<li>Ho\u1eb7c t\u1ec9 l\u1ec7 protein\/creatinine \u2265 0,3 (mg\/dL m\u1ed7i gi\u00e1 tr\u1ecb).<\/li>\n<li>Dipstick 1+ (ch\u1ec9 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng n\u1ebfu ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ecbnh l\u01b0\u1ee3ng kh\u00e1c kh\u00f4ng c\u00f3 s\u1eb5n).<\/li>\n<\/ul>\n<p>Ho\u1eb7c trong tr\u01b0\u1eddng h\u1ee3p Protein ni\u1ec7u \u00e2m t\u00ednh, THA m\u1edbi kh\u1edfi ph\u00e1t k\u00e8m theo v\u1edbi b\u1ea5t k\u1ef3 d\u1ea5u hi\u1ec7u n\u00e0o m\u1edbi kh\u1edfi ph\u00e1t sau \u0111\u00e2y:<\/p>\n<p>+ Gi\u1ea3m ti\u1ec3u c\u1ea7u: &lt; 100.000\/mm<sup>3<\/sup>.<\/p>\n<p>+ Suy th\u1eadn: N\u1ed3ng \u0111\u1ed9 creatinine\/huy\u1ebft thanh &gt; 1,1 mg\/dL ho\u1eb7c t\u0103ng g\u1ea5p \u0111\u00f4i n\u1ed3ng \u0111\u1ed9 creatinine huy\u1ebft thanh trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 b\u1ec7nh th\u1eadn kh\u00e1c.<\/p>\n<p>+ Suy ch\u1ee9c n\u0103ng gan: men gan t\u0103ng \u2265 2 l\u1ea7n gi\u00e1 tr\u1ecb b\u00ecnh th\u01b0\u1eddng.<\/p>\n<p>+ Ph\u00f9 ph\u1ed5i.<\/p>\n<p>+ Tri\u1ec7u ch\u1ee9ng n\u00e3o ho\u1eb7c th\u1ecb gi\u00e1c.<\/p>\n<p><em>Ti\u00eau chu\u1ea9n ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng (b\u1ea5t k\u1ef3 d\u1ea5u hi\u1ec7u n\u00e0o):<\/em><\/p>\n<ul>\n<li>T\u0103ng HA tr\u1ea7m tr\u1ecdng: HA t\u00e2m thu \u2265 160 mmHg ho\u1eb7c HA t\u00e2m tr\u01b0\u01a1ng \u2265 110 mmHg qua 2 l\u1ea7n \u0111o c\u00e1ch nhau 4 gi\u1edd c\u00f3 ngh\u1ec9 ng\u01a1i t\u1ea1i gi\u01b0\u1eddng (ngo\u1ea1i tr\u1eeb \u0111\u00e3 s\u1eed d\u1ee5ng thu\u1ed1c h\u1ea1 \u00e1p tr\u01b0\u1edbc \u0111\u00f3).<\/li>\n<li>Ti\u1ec3u c\u1ea7u &lt; 100.000\/mm<sup>3<\/sup>.<\/li>\n<li>Suy ch\u1ee9c n\u0103ng gan: men gan t\u0103ng g\u1ea5p \u0111\u00f4i b\u00ecnh th\u01b0\u1eddng. \u0110au h\u1ea1 s\u01b0\u1eddn ph\u1ea3i ho\u1eb7c th\u01b0\u1ee3ng v\u1ecb k\u00e9o d\u00e0i kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c v\u00e0 kh\u00f4ng c\u00f3 ch\u1ea9n \u0111o\u00e1n thay th\u1ebf, ho\u1eb7c c\u1ea3 hai.<\/li>\n<li>Suy th\u1eadn ti\u1ebfn tri\u1ec3n: N\u1ed3ng \u0111\u1ed9 creatinine\/huy\u1ebft thanh &gt; 1,1 mg\/dL ho\u1eb7c t\u0103ng g\u1ea5p \u0111\u00f4i n\u1ed3ng \u0111\u1ed9 creatinine huy\u1ebft thanh trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 b\u1ec7nh th\u1eadn kh\u00e1c.<\/li>\n<li>Ph\u00f9 ph\u1ed5i.<\/li>\n<li>R\u1ed1i lo\u1ea1n n\u00e3o ho\u1eb7c th\u1ecb gi\u00e1c (tri\u1ec7u ch\u1ee9ng th\u1ea7n kinh trung \u01b0\u01a1ng): r\u1ed1i lo\u1ea1n th\u1ecb gi\u00e1c (hoa m\u1eaft, \u00e1m \u0111i\u1ec3m, m\u00f9 v\u1ecf n\u00e3o, co th\u1eaft m\u1ea1ch m\u00e1u v\u00f5ng m\u1ea1c); nh\u1ee9c \u0111\u1ea7u nhi\u1ec1u, nh\u1ee9c \u0111\u1ea7u dai d\u1eb3ng, t\u0103ng l\u00ean, kh\u00f4ng \u0111\u00e1p \u1ee9ng thu\u1ed1c gi\u1ea3m \u0111au; thay \u0111\u1ed5i tri gi\u00e1c.<\/li>\n<\/ul>\n<p>&#8211; <strong>S\u1ea3n gi\u1eadt<\/strong>: \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n khi c\u00f3 c\u01a1n co gi\u1eadt x\u1ea3y ra tr\u00ean m\u1ed9t ph\u1ee5 n\u1eef mang thai \u0111\u00e3 c\u00f3 s\u1eb5n tri\u1ec7u ch\u1ee9ng ti\u1ec1n s\u1ea3n gi\u1eadt v\u00e0 kh\u00f4ng c\u00f3 nguy\u00ean nh\u00e2n n\u00e0o kh\u00e1c c\u00f3 th\u1ec3 gi\u1ea3i th\u00edch \u0111\u01b0\u1ee3c. C\u00e1c c\u01a1n co gi\u1eadt trong s\u1ea3n gi\u1eadt th\u01b0\u1eddng l\u00e0 to\u00e0n th\u00e2n, c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n tr\u01b0\u1edbc, trong chuy\u1ec3n d\u1ea1 hay trong th\u1eddi k\u1ef3 h\u1eadu s\u1ea3n, trong v\u00f2ng 48 gi\u1edd sau sinh ho\u1eb7c c\u00f3 th\u1ec3 ch\u1eadm h\u01a1n \u0111\u1ebfn 10 ng\u00e0y sau sinh, nh\u1ea5t l\u00e0 \u1edf con so.<\/p>\n<p><em>H\u1ed9i ch\u1ee9ng HELLP<\/em>: t\u00e1n huy\u1ebft (<strong>H<\/strong>emolysis) + t\u0103ng men gan (<strong>E<\/strong>levated <strong>L<\/strong>iver Enzyme) + gi\u1ea3m ti\u1ec3u c\u1ea7u (<strong>L<\/strong>ow <strong>P<\/strong>latelet Count).<\/p>\n<p>+ X\u1ea3y ra tr\u01b0\u1edbc v\u00e0 sau sinh.<\/p>\n<p>+ L\u00e2m s\u00e0ng: \u0111au v\u00f9ng th\u01b0\u1ee3ng v\u1ecb ho\u1eb7c h\u1ea1 s\u01b0\u1eddn ph\u1ea3i, nh\u00ecn m\u1edd, nh\u1ee9c \u0111\u1ea7u, v\u00e0ng da, bu\u1ed3n n\u00f4n, n\u00f4n.<\/p>\n<p>+ C\u1eadn l\u00e2m s\u00e0ng: d\u1ea5u hi\u1ec7u t\u00e1n huy\u1ebft (LDH t\u0103ng &gt; 600 UI\/L, Bilirubin gi\u00e1n ti\u1ebfp t\u0103ng), t\u0103ng men gan v\u00e0 gi\u1ea3m ti\u1ec3u c\u1ea7u.<\/p>\n<p>+ 15 \u2013 20% h\u1ed9i ch\u1ee9ng n\u00e0y kh\u00f4ng c\u00f3 t\u0103ng huy\u1ebft \u00e1p, ho\u1eb7c kh\u00f4ng c\u00f3 protein ni\u1ec7u.<\/p>\n<p><strong>&#8211; T\u0103ng huy\u1ebft \u00e1p m\u1ea1n<\/strong>: HA t\u00e2m thu \u2265 140 mmHg v\u00e0\/ho\u1eb7c HA t\u00e2m tr\u01b0\u01a1ng \u2265 90 mmHg tr\u01b0\u1edbc khi c\u00f3 thai, ho\u1eb7c x\u1ea3y ra tr\u01b0\u1edbc tu\u1ea7n l\u1ec5 20 c\u1ee7a thai k\u1ef3 v\u00e0 k\u00e9o d\u00e0i sau 12 tu\u1ea7n h\u1eadu s\u1ea3n.<\/p>\n<p><strong>&#8211; Ti\u1ec1n s\u1ea3n gi\u1eadt tr\u00ean n\u1ec1n t\u0103ng huy\u1ebft \u00e1p m\u1ea1n<\/strong>: ng\u01b0\u1eddi b\u1ec7nh c\u00f3 t\u0103ng HA tr\u01b0\u1edbc tu\u1ea7n l\u1ec5 20, protein ni\u1ec7u (+) tr\u01b0\u1edbc ho\u1eb7c sau tu\u1ea7n l\u1ec5 20, c\u1ea7n ph\u1ea3i t\u0103ng li\u1ec1u thu\u1ed1c \u0111i\u1ec1u tr\u1ecb HA, t\u0103ng men gan \u0111\u1ed9t ng\u1ed9t, gi\u1ea3m ti\u1ec3u c\u1ea7u, \u0111au \u00bc tr\u00ean ph\u1ea3i, sung huy\u1ebft ph\u1ed5i hay ph\u00f9 ph\u1ed5i, gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn ho\u1eb7c \u0111\u1ed9t ng\u1ed9t t\u0103ng ti\u1ec3u \u0111\u1ea1m. Th\u01b0\u1eddng ti\u1ec1n s\u1ea3n gi\u1eadt tr\u00ean n\u1ec1n t\u0103ng HA m\u1ea1n xu\u1ea5t hi\u1ec7n s\u1edbm h\u01a1n ti\u1ec1n s\u1ea3n gi\u1eadt \u0111\u01a1n thu\u1ea7n, n\u1eb7ng h\u01a1n v\u00e0 thai nhi th\u01b0\u1eddng k\u00e9m ph\u00e1t tri\u1ec3n h\u01a1n.<\/p>\n<p><strong>&#8211; T\u0103ng huy\u1ebft \u00e1p trong thai k\u1ef3<\/strong>: t\u0103ng HA sau tu\u1ea7n l\u1ec5 20, protein ni\u1ec7u (-), kh\u00f4ng c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u k\u1ec3 tr\u00ean v\u00e0 HA tr\u1edf v\u1ec1 b\u00ecnh th\u01b0\u1eddng tr\u01b0\u1edbc tu\u1ea7n l\u1ec5 12 c\u1ee7a th\u1eddi k\u1ef3 h\u1eadu s\u1ea3n \u00e0 Ch\u1ea9n \u0111o\u00e1n \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh sau th\u1eddi k\u1ef3 h\u1eadu s\u1ea3n.<\/p>\n<h2><strong>2.\u00a0\u00a0\u00a0 <\/strong><strong>\u0110\u1eb7c \u0111i\u1ec3m c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb trong ti\u1ec1n s\u1ea3n gi\u1eadt.<\/strong><\/h2>\n<p>Thu\u1ed1c trong \u0111i\u1ec1u tr\u1ecb ti\u1ec1n s\u1ea3n gi\u1eadt g\u1ed3m c\u00f3 c\u00e1c thu\u1ed1c ch\u1ed1ng t\u0103ng huy\u1ebft \u00e1p v\u00e0 thu\u1ed1c ng\u1eeba co gi\u1eadt. Thu\u1ed1c ch\u1ed1ng t\u0103ng huy\u1ebft \u00e1p l\u00e0 \u0111i\u1ec1u tr\u1ecb n\u1ec1n t\u1ea3ng. Thu\u1ed1c ng\u1eeba co gi\u1eadt ch\u1ec9 ng\u0103n c\u1ea3n s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a c\u01a1n co gi\u1eadt, m\u00e0 kh\u00f4ng t\u00e1c \u0111\u1ed9ng l\u00ean c\u01a1 ch\u1ebf g\u00e2y co gi\u1eadt, do \u0111\u00f3 kh\u00f4ng l\u00e0m c\u1ea3i thi\u1ec7n c\u01a1 ch\u1ebf b\u1ec7nh sinh.<\/p>\n<p>Thu\u1ed1c ch\u1ed1ng t\u0103ng huy\u1ebft \u00e1p \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh khi c\u00f3 t\u00ecnh tr\u1ea1ng t\u0103ng huy\u1ebft \u00e1p n\u1eb7ng: HA t\u00e2m thu \u2265 150 mmHg ho\u1eb7c HA t\u00e2m tr\u01b0\u01a1ng \u2265 100 mmHg.<\/p>\n<p>Thu\u1ed1c l\u1ee3i ti\u1ec3u l\u00e0m gi\u1ea3m Na<sup>+<\/sup> v\u00e0 th\u1ec3 t\u00edch d\u1ecbch l\u01b0u h\u00e0nh kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng trong ti\u1ec1n s\u1ea3n gi\u1eadt v\u00ec l\u00e0m suy gi\u1ea3m tu\u1ea7n ho\u00e0n t\u1eed cung \u2013 nhau. Kh\u00f4ng d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n do nguy c\u01a1 g\u00e2y d\u1ecb t\u1eadt thai nhi.<\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"162\">Thu\u1ed1c<\/td>\n<td width=\"225\">C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng<\/td>\n<td width=\"432\">C\u00e1ch d\u00f9ng<\/td>\n<td width=\"261\">\u1ea2nh h\u01b0\u1edfng<\/td>\n<\/tr>\n<tr>\n<td width=\"162\"><strong>Alpha methyldopa<\/strong><\/p>\n<p>(Aldomet)<\/td>\n<td width=\"225\">\u1ee8c ch\u1ebf th\u1ee5 th\u1ec3 alpha trung \u01b0\u01a1ng n\u00ean \u1ee9c ch\u1ebf giao c\u1ea3m<\/td>\n<td width=\"432\">D\u1ea1ng thu\u1ed1c:<\/p>\n<p>&#8211; Vi\u00ean n\u00e9n: 125 mg, 250 mg v\u00e0 500 mg.<\/p>\n<p>&#8211; H\u1ed7n d\u1ecbch u\u1ed1ng: 250mg\/5ml.<\/p>\n<p>Li\u1ec1u d\u00f9ng v\u1edbi vi\u00ean 250mg:<\/p>\n<p>&#8211; Kh\u1edfi \u0111\u1ea7u 1 \u2013 3 vi\u00ean\/ng\u00e0y.<\/p>\n<p>&#8211; Li\u1ec1u t\u1ed1i \u0111a 8 vi\u00ean\/ng\u00e0y.<\/td>\n<td width=\"261\">T\u00e1c d\u1ee5ng ph\u1ee5: tr\u1ea7m c\u1ea3m, bu\u1ed3n ng\u1ee7, ch\u00f3ng m\u1eb7t, thay \u0111\u1ed5i ch\u1ee9c n\u0103ng gan.<\/p>\n<p>Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh (CC\u0110): vi\u00eam gan c\u1ea5p t\u00ednh, m\u1ea1n t\u00ednh ho\u1eb7c x\u01a1 gan, ti\u1ec1n s\u1eed vi\u00eam gan do thu\u1ed1c, thi\u1ebfu m\u00e1u t\u00e1n huy\u1ebft, tr\u1ea7m c\u1ea3m tr\u1ea7m tr\u1ecdng.<\/td>\n<\/tr>\n<tr>\n<td width=\"162\"><strong>Hydralazin<\/strong><\/p>\n<p>(Nepressol)<\/td>\n<td width=\"225\">T\u00e1c d\u1ee5ng tr\u1ef1c ti\u1ebfp tr\u00ean c\u01a1 tr\u01a1n th\u00e0nh m\u1ea1ch n\u00ean g\u00e2y gi\u00e3n m\u1ea1ch ngo\u1ea1i vi<\/td>\n<td width=\"432\">\u0110\u01b0\u1ee3c h\u1ea5p th\u1ee5 nhanh ch\u00f3ng v\u00e0 h\u1ea7u nh\u01b0 ho\u00e0n to\u00e0n sau u\u1ed1ng.<\/p>\n<p>D\u1ea1ng thu\u1ed1c:<\/p>\n<p>&#8211; Vi\u00ean n\u00e9n: 10 mg, 25 mg v\u00e0 50 mg.<\/p>\n<p>&#8211; \u1ed0ng ti\u00eam 25mg\/1ml.<\/p>\n<p>C\u00e1ch d\u00f9ng:<\/p>\n<p>&#8211; Ti\u00eam TM 5mg Hydralazin trong 1 \u2013 2 ph\u00fat, sau \u0111\u00f3 5 \u2013 10 mg m\u1ed7i 20 \u2013 40 ph\u00fat. Ho\u1eb7c TTM 0,5 \u2013 10 mg\/gi\u1edd.<\/p>\n<p>&#8211; N\u1ebfu t\u1ed5ng li\u1ec1u 30 mg kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c HA n\u00ean chuy\u1ec3n thu\u1ed1c kh\u00e1c.<\/p>\n<p>&#8211; HA s\u1ebd h\u1ea1 sau 10 \u2013 30 ph\u00fat v\u00e0 k\u00e9o d\u00e0i t\u1eeb 2 \u2013 4 gi\u1edd.<\/td>\n<td width=\"261\">T\u00e1c d\u1ee5ng ph\u1ee5 l\u00e0 h\u1ea1 HA \u0111\u1ed9t ng\u1ed9t g\u00e2y suy thai n\u00ean kh\u00f4ng d\u00f9ng \u0111\u01a1n \u0111\u1ed9c m\u00e0 th\u01b0\u1eddng k\u1ebft h\u1ee3p v\u1edbi m\u1ed9t \u1ee9c ch\u1ebf alpha adrenergic kh\u00e1c nh\u01b0 Labetalol hay Propranolol. Ngo\u00e0i ra c\u00f2n c\u00f3 nh\u1ecbp tim nhanh, \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c, \u0111au th\u1eaft ng\u1ef1c, t\u1ee5t HA, ti\u00eau ch\u1ea3y, t\u00e1o b\u00f3n, n\u1ed5i m\u1ea9n\u2026<\/p>\n<p>CC\u0110: b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh, qu\u00e1 m\u1eabn v\u1edbi Hydralazin, van 2 l\u00e1 do th\u1ea5p, lupus ban \u0111\u1ecf, ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 c\u1ea5p.<\/td>\n<\/tr>\n<tr>\n<td width=\"162\"><strong>Labetalol<\/strong><\/p>\n<p>(Trandate)<\/td>\n<td width=\"225\">\u1ee8c ch\u1ebf th\u1ee5 th\u1ec3 alpha v\u00e0 beta giao c\u1ea3m<\/td>\n<td width=\"432\">B\u1eaft \u0111\u1ea7u t\u00e1c d\u1ee5ng sau ti\u00eam TM 5 ph\u00fat, m\u1ea5t 1 \u2013 2 gi\u1edd \u0111\u1ec3 \u0111\u1ea1t n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh trong m\u00e1u.<\/p>\n<p>D\u00f9ng t\u1ed1t cho b\u1ec7nh nh\u00e2n c\u00f3 k\u00e8m \u0111au th\u1eaft ng\u1ef1c, ho\u1eb7c nh\u1ee9c n\u1eeda \u0111\u1ea7u.<\/p>\n<p>D\u1ea1ng thu\u1ed1c:<\/p>\n<p>&#8211; Vi\u00ean n\u00e9n 100 mg, 200 mg v\u00e0 300 mg.<\/p>\n<p>&#8211; \u1ed0ng ti\u00eam 5mg\/1ml.<\/p>\n<p>&#8211; Dd ti\u00eam truy\u1ec1n 100mg\/ 20ml<\/p>\n<p>C\u00e1ch d\u00f9ng:<\/p>\n<p>&#8211; T\u1ea5n c\u00f4ng: b\u1eaft \u0111\u1ea7u 10 \u2013 20 mg TM, sau \u0111\u00f3 TM 20mg \u0111\u1ebfn 80mg m\u1ed7i 20 \u2013 30 ph\u00fat, t\u1ed5ng li\u1ec1u t\u1ea5n c\u00f4ng &lt; 300 mg. C\u00f3 th\u1ec3 truy\u1ec1n TM 1 \u2013 2 mg\/ph\u00fat. HA s\u1ebd h\u1ea1 sau 5 \u2013 10 ph\u00fat v\u00e0 k\u00e9o d\u00e0i t\u1eeb 3 \u2013 6 gi\u1edd.<\/p>\n<p>&#8211; Duy tr\u00ec (khi HA \u1ed5n \u0111\u1ecbnh): u\u1ed1ng 100 \u2013 200 mg x 2 \u2013 3 l\u1ea7n m\u1ed7i ng\u00e0y, t\u1ed1i \u0111a 1200 mg\/24h<\/td>\n<td width=\"261\">CC\u0110: suy\u1ec5n, b\u1ec7nh tim, suy tim sung huy\u1ebft.<\/td>\n<\/tr>\n<tr>\n<td width=\"162\"><strong>Nifedipin<\/strong><\/p>\n<p>(Adalate)<\/td>\n<td width=\"225\">\u1ee8c ch\u1ebf k\u00eanh Canxi<\/td>\n<td width=\"432\">L\u00e0m gi\u1ea3m huy\u1ebft \u00e1p m\u00e0 kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn l\u01b0u l\u01b0\u1ee3ng m\u00e1u qua nhau thai.<\/p>\n<p>D\u1ea1ng thu\u1ed1c:<\/p>\n<p>&#8211; Vi\u00ean nang m\u1ec1m: 10mg, c\u00f3 th\u1ec3 u\u1ed1ng ho\u1eb7c \u0111\u1eb7t d\u01b0\u1edbi l\u01b0\u1ee1i.<\/p>\n<p>&#8211; Vi\u00ean n\u00e9n bao phim t\u00e1c d\u1ee5ng ch\u1eadm 20mg.<\/p>\n<p>&#8211; Vi\u00ean ph\u00f3ng th\u00edch k\u00e9o d\u00e0i 30mg ho\u1eb7c 60mg.<\/p>\n<p>C\u00e1ch d\u00f9ng:<\/p>\n<p>&#8211; U\u1ed1ng 20 \u2013 30 mg\/20 \u2013 30 ph\u00fat, t\u1ed1i \u0111a 50mg.<\/p>\n<p>&#8211; Sau \u0111\u00f3, 10 \u2013 20 mg\/4 \u2013 6 gi\u1edd (t\u1ed1i \u0111a 120 mg\/ng\u00e0y) \u0111\u1ec3 duy tr\u00ec HA mong mu\u1ed1n.<\/td>\n<td width=\"261\">Nifedipin c\u00f3 kh\u1ea3 n\u0103ng t\u01b0\u01a1ng t\u00e1c v\u1edbi magnesium sulfate (do Mg<sup>2+<\/sup> c\u1ea1nh tranh v\u1edbi Ca<sup>2+<\/sup>) n\u00ean c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u1ee5t HA.<\/p>\n<p>T\u00e1c d\u1ee5ng ph\u1ee5 kh\u00e1c: tim \u0111\u1eadp nhanh, nh\u1ee9c \u0111\u1ea7u v\u00e0 h\u1ed3i h\u1ed9p.<\/td>\n<\/tr>\n<tr>\n<td width=\"162\"><strong>Nicardipin<\/strong><\/td>\n<td width=\"225\">\u1ee8c ch\u1ebf k\u00eanh Canxi<\/td>\n<td width=\"432\">L\u00e0 thu\u1ed1c h\u1ea1 \u00e1p m\u1ea1nh c\u00f3 th\u1ec3 d\u00f9ng trong ti\u1ec3n s\u1ea3n gi\u1eadt khi c\u00e1c thu\u1ed1c kh\u00e1c th\u1ea5t b\u1ea1i.<\/p>\n<p>Nicardipin t\u00e1c d\u1ee5ng ch\u1ecdn l\u1ecdc tr\u00ean m\u1ea1ch m\u00e1u h\u01a1n n\u00ean \u00edt g\u00e2y t\u0103ng nh\u1ecbp tim h\u01a1n Nifedipin.<\/p>\n<p>Nicardipin c\u00f3 th\u1eddi gian b\u1eaft \u0111\u1ea7u t\u00e1c d\u1ee5ng kho\u1ea3ng 10 ph\u00fat, \u0111\u1ea1t \u0111\u1ec9nh sau 30 \u2013 120 ph\u00fat, t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i 8 gi\u1edd.<\/p>\n<p>D\u1ea1ng thu\u1ed1c:<\/p>\n<p>&#8211; Vi\u00ean nang 20 mg, 30 mg.<\/p>\n<p>&#8211; Vi\u00ean nang t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i: 30 mg, 40 mg, 45 mg, 60 mg.<\/p>\n<p>&#8211; Dd ti\u00eam 10mg\/10ml.<\/p>\n<p>C\u00e1ch d\u00f9ng:<\/p>\n<p>&#8211; U\u1ed1ng 20 mg x 3 l\u1ea7n\/ng\u00e0y.<\/p>\n<p>&#8211; Ho\u1eb7c truy\u1ec1n TM v\u1edbi li\u1ec1u t\u1ea5n c\u00f4ng 0,5 \u2013 1 mg bolus, sau \u0111\u00f3 duy tr\u00ec 2 mg m\u1ed7i gi\u1edd (pha m\u1ed9t \u1ed1ng Nicardipin trong 40 ml dung d\u1ecbch Glucose 5%, d\u00f9ng BT\u0110 truy\u1ec1n v\u1edbi t\u1ed1c \u0111\u1ed9 10 ml m\u1ed7i gi\u1edd).<\/td>\n<td width=\"261\">T\u00e1c d\u1ee5ng ph\u1ee5: \u0111au \u0111\u1ea7u, ch\u00f3ng m\u1eb7t, bu\u1ed3n n\u00f4n, n\u00f4n, \u0111au d\u1ea1 d\u00e0y.<\/p>\n<p>Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh: c\u01a1n \u0111au th\u1eaft ng\u1ef1c kh\u00f4ng \u1ed5n \u0111\u1ecbnh ho\u1eb7c c\u1ea5p t\u00ednh, s\u1ed1c tim, h\u1eb9p van \u0110m ch\u1ee7 giai \u0111o\u1ea1n mu\u1ed9n, th\u1eadn tr\u1ecdng khi d\u00f9ng trong 2 tam c\u00e1 nguy\u1ec7t \u0111\u1ea7u, c\u00f3 th\u1ec3 d\u00f9ng trong tam c\u00e1 nguy\u1ec7t ba.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Xem th\u00eam:<\/p>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/san-phu-khoa-va-ho-tro-sinh-san\/benh-tien-san-giat-nhung-dieu-me-bau-can-biet\/\">B\u1ec7nh ti\u1ec1n s\u1ea3n gi\u1eadt &#8211; Nh\u1eefng \u0111i\u1ec1u m\u1eb9 b\u1ea7u c\u1ea7n bi\u1ebft<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>T\u0103ng huy\u1ebft \u00e1p thai k\u1ef3 l\u00e0 m\u1ed9t nh\u00f3m l\u1edbn c\u00e1c b\u1ec7nh l\u00fd v\u1edbi b\u1ec7nh sinh kh\u00f4ng thu\u1ea7n nh\u1ea5t, \u0111\u00f2i h\u1ecfi c\u00e1c k\u1ebf ho\u1ea1ch qu\u1ea3n l\u00fd kh\u00e1c nhau. Nh\u1eadn di\u1ec7n, ph\u00e2n lo\u1ea1i c\u00e1c b\u1ec7nh l\u00fd t\u0103ng huy\u1ebft \u00e1p trong thai k\u1ef3 l\u00e0 m\u1ed9t b\u01b0\u1edbc quan tr\u1ecdng tr\u01b0\u1edbc khi \u0111\u1ec1 ra m\u1ed9t ph\u01b0\u01a1ng th\u1ee9c qu\u1ea3n l\u00fd th\u00edch [&hellip;]<\/p>\n","protected":false},"author":16,"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>T\u0103ng huy\u1ebft \u00e1p thai k\u1ef3: C\u00e1c bi\u1ec3u hi\u1ec7n v\u00e0 c\u00e1ch \u0111i\u1ec1u tr\u1ecb an to\u00e0n cho m\u1eb9 v\u00e0 thai nhi - Vinmec<\/title>\n<meta name=\"description\" content=\"T\u0103ng huy\u1ebft \u00e1p thai k\u1ef3 l\u00e0 m\u1ed9t nh\u00f3m l\u1edbn c\u00e1c b\u1ec7nh l\u00fd v\u1edbi b\u1ec7nh sinh kh\u00f4ng thu\u1ea7n nh\u1ea5t, \u0111\u00f2i h\u1ecfi c\u00e1c k\u1ebf ho\u1ea1ch qu\u1ea3n l\u00fd kh\u00e1c nhau.\" \/>\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=\"T\u0103ng huy\u1ebft \u00e1p thai k\u1ef3: C\u00e1c bi\u1ec3u hi\u1ec7n v\u00e0 c\u00e1ch \u0111i\u1ec1u tr\u1ecb an to\u00e0n cho m\u1eb9 v\u00e0 thai nhi - 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