{"id":2583,"date":"2023-06-19T08:13:10","date_gmt":"2023-06-19T01:13:10","guid":{"rendered":"https:\/\/bvndgiadinh.org.vn\/?p=2583"},"modified":"2023-06-20T13:51:14","modified_gmt":"2023-06-20T06:51:14","slug":"phau-thuat-thanh-cong-san-phu-bi-nhau-cai-rang-luoc-the-nang-va-hiem-gap","status":"publish","type":"post","link":"https:\/\/bvndgiadinh.org.vn\/?p=2583","title":{"rendered":"Ph\u1eabu thu\u1eadt th\u00e0nh c\u00f4ng s\u1ea3n ph\u1ee5 b\u1ecb nhau c\u00e0i r\u0103ng l\u01b0\u1ee3c th\u1ec3 n\u1eb7ng v\u00e0 hi\u1ebfm g\u1eb7p"},"content":{"rendered":"\n<p><strong><em>Ng\u00e0y 21\/05\/2023, S\u1ea3n ph\u1ee5 N.N.T, 38 tu\u1ed5i, ng\u1ee5 t\u1ea1i TPHCM nh\u1eadp B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh khi c\u00f3 thai \u1edf tu\u1ea7n th\u1ee9 32,5. K\u1ebft qu\u1ea3 kh\u00e1m v\u00e0 ki\u1ec3m tra cho th\u1ea5y s\u1ea3n ph\u1ee5 trong t\u00ecnh tr\u1ea1ng nhau ti\u1ec1n \u0111\u1ea1o trung t\u00e2m, nhau c\u00e0i r\u0103ng l\u01b0\u1ee3c th\u1ec3 Percreta \u2013 th\u1ec3 n\u1eb7ng nh\u1ea5t. B\u00e1nh nhau x\u00e2m l\u1ea5n xuy\u00ean qua c\u01a1 t\u1eed cung v\u00e0o l\u1edbp thanh m\u1ea1c t\u1eed cung. B\u00e1c s\u1ef9 nh\u1eadn \u0111\u1ecbnh \u0111\u00e2y l\u00e0 m\u1ed9t tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng c\u00f3 th\u1ec3 g\u00e2y nguy hi\u1ec3m \u0111\u1ebfn t\u00ednh m\u1ea1ng c\u1ee7a c\u1ea3 m\u1eb9 v\u00e0 con n\u00ean ngay l\u1eadp t\u1ee9c s\u1ea3n ph\u1ee5 \u0111\u01b0\u1ee3c nh\u1eadp vi\u1ec7n, l\u00ean ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p.<\/em><\/strong><\/p>\n\n\n\n<p>B\u00e1c s\u1ef9 ti\u00eam thu\u1ed1c h\u1ed7 tr\u1ee3 ph\u1ed5i cho s\u1ea3n ph\u1ee5 nh\u1eb1m d\u1ef1 ph\u00f2ng t\u00ecnh tr\u1ea1ng suy h\u00f4 h\u1ea5p c\u1ee7a thai nhi c\u00f3 nguy c\u01a1 b\u1ecb sinh non. K\u1ebft qu\u1ea3 ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb MRI x\u00e1c \u0111\u1ecbnh s\u1ea3n ph\u1ee5 c\u00f3 nhau ti\u1ec1n \u0111\u1ea1o trung t\u00e2m, nhau c\u00e0i r\u0103ng l\u01b0\u1ee3c th\u1ec3 Percreta. \u0110\u00e2y l\u00e0 th\u1ec3 \u00edt ph\u1ed5 bi\u1ebfn nh\u1ea5t nh\u01b0ng nghi\u00eam tr\u1ecdng nh\u1ea5t g\u00e2y m\u1ea5t m\u00e1u n\u1eb7ng nguy hi\u1ec3m t\u00ednh m\u1ea1ng ng\u01b0\u1eddi m\u1eb9 v\u00e0 sanh non ho\u1eb7c ch\u1ea5m d\u1ee9t thai k\u1ef3 \u0111\u1ed1i v\u1edbi thai nhi.Trong tr\u01b0\u1eddng h\u1ee3p c\u1ee7a s\u1ea3n ph\u1ee5, b\u00e1nh nhau x\u00e2m l\u1ea5n xuy\u00ean qua c\u01a1 t\u1eed cung v\u00e0o l\u1edbp thanh m\u1ea1c t\u1eed cung, r\u1ea5t c\u00f3 th\u1ec3 g\u00e2y b\u0103ng huy\u1ebft n\u1eb7ng, nguy c\u01a1 suy \u0111a t\u1ea1ng, nguy hi\u1ec3m t\u00ednh m\u1ea1ng v\u00e0 \u0111a s\u1ed1 tr\u01b0\u1eddng h\u1ee3p ph\u1ea3i c\u1eaft t\u1eed cung. B\u00e1c s\u1ef9 s\u1ea3n khoa \u0111\u00e3 h\u1ed9i ch\u1ea9n li\u00ean chuy\u00ean khoa v\u1edbi \u0110\u01a1n v\u1ecb X-Quang can thi\u1ec7p thu\u1ed9c khoa Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh nh\u1eb1m l\u00ean k\u1ebf ho\u1ea1ch can thi\u1ec7p n\u1ed9i m\u1ea1ch trong l\u00fac m\u1ed5 l\u1ea5y thai nh\u1eb1m h\u1ea1n ch\u1ebf m\u1ea5t m\u00e1u. Ng\u00e0y 26\/05\/2023 ca ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh v\u1edbi s\u1ef1 ph\u1ed1i h\u1ee3p c\u1ee7a c\u00e1c B\u00e1c s\u1ef9 G\u00e2y m\u00ea h\u1ed3i s\u1ee9c, \u0110\u01a1n v\u1ecb X-Quang can thi\u1ec7p, B\u1ec7nh l\u00fd s\u01a1 sinh.<\/p>\n\n\n\n<p>BS CK2 Nguy\u1ec5n Th\u1ecb Minh Huy\u1ec1n \u2013 Ph\u00f3 khoa S\u1ea3n th\u01b0\u1eddng \u2013 B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh cho bi\u1ebft:<em>\u201c S\u1ea3n ph\u1ee5 \u0111\u00e3 sinh m\u1ed5 3 l\u1ea7n, trong l\u1ea7n mang thai con th\u1ee9 4 n\u00e0y \u0111\u00e3 ph\u00e1t hi\u1ec7n nhau ti\u1ec1n \u0111\u1ea1o t\u1eeb tu\u1ea7n th\u1ee9 16 c\u1ee7a thai k\u1ef3. M\u1eb7c d\u00f9 c\u00f3 nhi\u1ec1u nguy c\u01a1 cho s\u1ee9c kho\u1ebb nh\u01b0ng s\u1ea3n ph\u1ee5 r\u1ea5t mong mu\u1ed1n gi\u1eef \u0111\u01b0\u1ee3c thai nhi n\u00ean c\u00e1c b\u00e1c s\u1ef9 r\u1ea5t n\u1ed7 l\u1ef1c \u0111\u1ec3 k\u00e9o d\u00e0i th\u1eddi gian d\u01b0\u1ee1ng thai.<\/em> <em>L\u00fac thai \u0111\u01b0\u1ee3c 33 tu\u1ea7n 3 ng\u00e0y th\u00ec thai ph\u1ee5 b\u1eaft \u0111\u1ea7u ra m\u00e1u \u00e2m \u0111\u1ea1o, kh\u00f4ng th\u1ec3 d\u01b0\u1ee1ng thai th\u00eam n\u00ean c\u00f3 ch\u1ec9 \u0111\u1ecbnh ch\u1ea5m d\u1ee9t thai k\u1ef3. Cu\u1ed9c ph\u1eabu thu\u1eadt di\u1ec5n ra v\u00e0o tu\u1ea7n th\u1ee9 33,5 c\u1ee7a thai k\u1ef3. Nhau c\u00e0i r\u0103ng l\u01b0\u1ee3c l\u1ea1i l\u00e0 th\u1ec3 Percreta lu\u00f4n l\u00e0 m\u1ed9t th\u00e1ch th\u1ee9c v\u1edbi c\u00e1c b\u00e1c s\u1ef9 b\u1edfi nguy c\u01a1 m\u1ea5t m\u00e1u, g\u00e2y nguy hi\u1ec3m t\u00ednh m\u1ea1ng cho c\u1ea3 m\u1eb9 v\u00e0 con lu\u00f4n th\u01b0\u1eddng tr\u1ef1c d\u00f9 c\u00f3 \u0111\u01b0\u1ee3c chu\u1ea9n b\u1ecb k\u1ef9. B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh c\u00f3 l\u1ee3i th\u1ebf l\u00e0 b\u1ec7nh vi\u1ec7n \u0111a khoa n\u00ean \u00eakip \u0111\u00e3 thu\u1eadn l\u1ee3i trong vi\u1ec7c m\u1ed5 l\u1ea5y thai k\u1ebft h\u1ee3p \u0111\u1eb7t b\u00f3ng ch\u00e8n \u0111\u1ed9ng m\u1ea1ch ch\u1eadu trong trong l\u00fac m\u1ed5. L\u01b0\u1ee3ng m\u00e1u m\u1ea5t ch\u1ec9 b\u1eb1ng m\u1ed9t n\u1eeda so v\u1edbi c\u00e1c ca m\u1ed5 nhau c\u00e0i r\u0103ng l\u01b0\u1ee3c tr\u01b0\u1edbc \u0111\u00e2y. \u0110i\u1ec1u quan tr\u1ecdng nh\u1ea5t l\u00e0 b\u1ea3o t\u1ed3n \u0111\u01b0\u1ee3c t\u1eed cung,&nbsp; kh\u00f4ng b\u1ecb c\u1eaft \u0111i\u201d.<\/em><\/p>\n\n\n\n<div class=\"wp-block-uagb-image aligncenter uagb-block-5d6bb5e7 wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-center\"><figure class=\"wp-block-uagb-image__figure\"><img decoding=\"async\" src=\"https:\/\/bvndgiadinh.org.vn\/wp-content\/uploads\/2023\/06\/1-2-1024x770.jpg\" alt=\"\" class=\"uag-image-2584\" width=\"1024\" height=\"770\" title=\"\" loading=\"lazy\" \/><\/figure><\/div>\n\n\n\n<p>Sau ca ph\u1eabu thu\u1eadt k\u00e9o d\u00e0i 2 gi\u1edd \u0111\u1ed3ng h\u1ed3, s\u1ea3n ph\u1ee5 ti\u1ebfp t\u1ee5c \u0111\u01b0\u1ee3c theo d\u00f5i t\u00edch c\u1ef1c t\u1ea1i khoa S\u1ea3n th\u01b0\u1eddng v\u00e0 xu\u1ea5t vi\u1ec7n sau \u0111\u00f3 7 ng\u00e0y. L\u00fac n\u00e0y c\u00e1c b\u00e1c s\u1ef9 Khoa B\u1ec7nh l\u00fd s\u01a1 sinh l\u1ea1i g\u1eb7p m\u1ed9t th\u00e1ch th\u1ee9c kh\u00e1c khi \u0111i\u1ec1u tr\u1ecb cho tr\u1ebb sinh non th\u00e1ng c\u1ee7a s\u1ea3n ph\u1ee5. B\u00e9 trai c\u00e2n n\u1eb7ng 2400 gram, non th\u00e1ng, suy h\u00f4 h\u1ea5p, nhi\u1ec5m tr\u00f9ng huy\u1ebft, c\u00f2n \u1ed1ng \u0111\u1ed9ng m\u1ea1ch c\u00f3 \u0111\u01b0\u1eddng k\u00ednh \u1ed1ng to \u1ea3nh h\u01b0\u1edfng t\u1edbi tu\u1ea7n ho\u00e0n m\u00e1u, th\u00f4ng li\u00ean nh\u0129, v\u00e0ng da t\u0103ng bilirubin gi\u00e1n ti\u1ebfp. C\u00e1c b\u00e1c s\u0129 n\u1ed7 l\u1ef1c t\u00edch c\u1ef1c \u0111i\u1ec1u tr\u1ecb cho tr\u1ebb v\u00e0 ti\u1ebfn h\u00e0nh \u0111\u00f3ng th\u00e0nh c\u00f4ng \u1ed1ng \u0111\u1ed9ng m\u1ea1ch b\u1eb1ng thu\u1ed1c sau 20 ng\u00e0y \u0111i\u1ec1u tr\u1ecb. Ng\u00e0y 15\/06\/2023, b\u00e9 \u0111\u01b0\u1ee3c xu\u1ea5t vi\u1ec7n trong v\u00f2ng tay m\u1eb9 v\u1edbi s\u1ef1 vui m\u1eebng, h\u1ea1nh ph\u00fac c\u1ee7a gia \u0111\u00ecnh.<\/p>\n\n\n\n<p>TS.BS B\u00f9i Ch\u00ed Th\u01b0\u01a1ng \u2013 Tr\u01b0\u1edfng kh\u1ed1i S\u1ea3n \u2013 B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh cho bi\u1ebft: <em>\u201cNhau thai l\u00e0 b\u1ed9 ph\u1eadn ph\u00e1t tri\u1ec3n b\u00ean trong t\u1eed cung l\u00e0m nhi\u1ec7m v\u1ee5 cung c\u1ea5p dinh d\u01b0\u1ee1ng, oxy\u2026 nu\u00f4i d\u01b0\u1ee1ng b\u00e0o thai \u0111\u01b0\u1ee3c k\u1ebft n\u1ed1i qua d\u00e2y r\u1ed1n. Khi em b\u00e9 \u0111\u01b0\u1ee3c sinh ra th\u00ec ch\u1ee9c n\u0103ng c\u1ee7a nhau thai c\u0169ng ch\u1ea5m d\u1ee9t, \u0111\u1ed3ng ngh\u0129a v\u1edbi vi\u1ec7c n\u00f3 s\u1ebd ph\u1ea3i \u0111\u01b0\u1ee3c \u0111\u00e0o th\u1ea3i h\u1ebft ra ngo\u00e0i c\u01a1 th\u1ec3. Nh\u01b0ng trong m\u1ed9t v\u00e0i tr\u01b0\u1eddng h\u1ee3p, nhau thai kh\u00f4ng t\u1ef1 bong ra m\u1ed9t c\u00e1ch t\u1ef1 nhi\u00ean m\u00e0 d\u00ednh ch\u1eb7t tr\u00ean th\u00e0nh t\u1eed cung, t\u00ecnh tr\u1ea1ng n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 nhau c\u00e0i r\u0103ng l\u01b0\u1ee3c. V\u1edbi nh\u1eefng ca ph\u1eabu thu\u1eadt nh\u01b0 v\u1eady, th\u01b0\u1eddng g\u00e2y ch\u1ea3y m\u00e1u kh\u00f4ng th\u1ec3 c\u1ea7m, d\u1eabn \u0111\u1ebfn nhi\u1ec1u bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m nh\u01b0 b\u0103ng huy\u1ebft sau sinh ph\u1ea3i truy\u1ec1n m\u1ed9t l\u01b0\u1ee3ng m\u00e1u l\u1edbn, kho\u1ea3ng 5 l\u00edt, \u0111e d\u1ecda t\u00ednh m\u1ea1ng ng\u01b0\u1eddi m\u1eb9 v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng ph\u1ea3i c\u1eaft b\u1ecf t\u1eed cung \u0111\u1ec3 c\u1ea7m m\u00e1u.T\u1ea1i b\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh c\u00f3 \u0111\u1ea7y \u0111\u1ee7 c\u00e1c chuy\u00ean khoa s\u00e2u, trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y l\u00e0 s\u1ef1 ph\u1ed1i h\u1ee3p c\u1ee7a X quang can thi\u1ec7p v\u1edbi k\u1ef9 thu\u1eadt \u0111\u1eb7t b\u00f3ng ch\u00e8n \u0111\u1ed9ng m\u1ea1ch ch\u1eadu \u0111\u00e3 &nbsp;gi\u00fap cho b\u00e1c s\u1ef9 s\u1ea3n khoa m\u1ed5 nh\u1eb9 nh\u00e0ng, \u0111em l\u1ea1i l\u1ee3i \u00edch cho thai ph\u1ee5 l\u00e0 \u00edt m\u1ea5t m\u00e1u v\u00e0 gi\u1eef \u0111\u01b0\u1ee3c t\u1eed cung. Vai tr\u00f2 c\u1ee7a Khoa B\u1ec7nh l\u00fd s\u01a1 sinh c\u0169ng r\u1ea5t quan tr\u1ecdng,&nbsp; \u0111\u00f3 l\u00e0 \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng cho tr\u1ebb non th\u00e1ng c\u00f3 b\u1ec7nh tim b\u1ea9m sinh.\u201d<\/em><\/p>\n\n\n\n<p>M\u1ed9t trong nh\u1eefng c\u00e1ch gi\u1ea3m nguy c\u01a1 m\u1eafc ph\u1ea3i nhau c\u00e0i r\u0103ng l\u01b0\u1ee3c \u1edf nh\u1eefng l\u1ea7n mang thai sau l\u00e0 m\u1eb9 b\u1ea7u n\u00ean sinh ng\u1ea3 \u00e2m \u0111\u1ea1o thay v\u00ec sinh m\u1ed5 n\u1ebfu kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh m\u1ed5 l\u1ea5y thai c\u1ee7a b\u00e1c s\u0129.&nbsp;Ng\u1eeba thai hi\u1ec7u qu\u1ea3, sinh \u0111\u1ebb c\u00f3 k\u1ebf ho\u1ea1ch, kh\u00f4ng n\u1ea1o, h\u00fat thai. Kh\u00f4ng n\u00ean sinh qu\u00e1 nhi\u1ec1u con: sau m\u1ed7i l\u1ea7n sinh, t\u1eed cung s\u1ebd y\u1ebfu d\u1ea7n, t\u0103ng nguy c\u01a1 m\u1eafc b\u1ec7nh. Kh\u00e1m thai \u0111\u1ecbnh k\u1ef3, si\u00eau \u00e2m ph\u00e1t hi\u1ec7n s\u1edbm nhau c\u00e0i r\u0103ng l\u01b0\u1ee3c.<\/p>\n\n\n\n<div class=\"wp-block-uagb-image aligncenter uagb-block-855fb97a wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-center\"><figure class=\"wp-block-uagb-image__figure\"><img decoding=\"async\" src=\"https:\/\/bvndgiadinh.org.vn\/wp-content\/uploads\/2023\/06\/2.jpg\" alt=\"\" class=\"uag-image-2585\" width=\"1380\" height=\"706\" title=\"\" loading=\"lazy\" \/><\/figure><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Ng\u00e0y 21\/05\/2023, S\u1ea3n ph\u1ee5 N.N.T, 38 tu\u1ed5i, ng\u1ee5 t\u1ea1i TPHCM nh\u1eadp B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh khi c\u00f3 thai \u1edf tu\u1ea7n th\u1ee9 32,5. K\u1ebft qu\u1ea3 kh\u00e1m v\u00e0 ki\u1ec3m tra cho th\u1ea5y s\u1ea3n ph\u1ee5 trong t\u00ecnh tr\u1ea1ng nhau ti\u1ec1n \u0111\u1ea1o trung t\u00e2m, nhau c\u00e0i r\u0103ng l\u01b0\u1ee3c th\u1ec3 Percreta \u2013 th\u1ec3 n\u1eb7ng nh\u1ea5t. B\u00e1nh nhau x\u00e2m 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