{"id":12924,"date":"2023-12-11T23:32:31","date_gmt":"2023-12-11T15:32:31","guid":{"rendered":"https:\/\/docquity.com\/?post_type=articles&#038;p=12924"},"modified":"2025-02-11T13:38:12","modified_gmt":"2025-02-11T05:38:12","slug":"huong-dan-dieu-tri-cua-rcog-2023-say-thai-lien-tiep","status":"publish","type":"articles","link":"https:\/\/docquity.com\/vi\/articles\/huong-dan-dieu-tri-cua-rcog-2023-say-thai-lien-tiep\/","title":{"rendered":"H\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb c\u1ee7a RCOG 2023: S\u1ea3y thai li\u00ean ti\u1ebfp"},"content":{"rendered":"\n<p>S\u1ea3y thai li\u00ean ti\u1ebfp \u0111\u01b0\u1ee3c Hi\u1ec7p h\u1ed9i S\u1ea3n Ph\u1ee5 khoa Ho\u00e0ng gia Anh (Royal College of Obstetricians and Gynaecologists \u2013 ROCG) \u0111\u1ecbnh ngh\u0129a l\u00e0 s\u1ea3y thai t\u1eeb 3 l\u1ea7n tr\u1edf l\u00ean v\u00e0o th\u1eddi k\u1ef3 tam c\u00e1 nguy\u1ec7t th\u1ee9 nh\u1ea5t. C\u00f3 kho\u1ea3ng 1% ph\u1ee5 n\u1eef g\u1eb7p ph\u1ea3i t\u00ecnh tr\u1ea1ng s\u1ea3y thai li\u00ean ti\u1ebfp. Nhi\u1ec1u b\u1eb1ng ch\u1ee9ng cho th\u1ea5y s\u1ea3y thai li\u00ean ti\u1ebfp l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng h\u01a1n l\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a bi\u1ebfn c\u1ed1\/tai n\u1ea1n ng\u1eabu nhi\u00ean x\u1ea3y ra nhi\u1ec1u l\u1ea7n. Y\u1ebfu t\u1ed1 quan tr\u1ecdng nh\u1ea5t c\u1ee7a nguy c\u01a1 s\u1ea3y thai li\u00ean ti\u1ebfp l\u00e0 tu\u1ed5i t\u00e1c. RCOG \u0111\u00e3 \u0111\u01b0a ra h\u01b0\u1edbng d\u1eabn phi\u00ean b\u1ea3n c\u1eadp nh\u1eadt n\u0103m 2023 nh\u1eb1m m\u1ee5c \u0111\u00edch h\u1ed7 tr\u1ee3 th\u0103m kh\u00e1m v\u00e0 ch\u0103m s\u00f3c ph\u1ee5 n\u1eef c\u00f3 t\u00ecnh tr\u1ea1ng s\u1ea3y thai li\u00ean ti\u1ebfp. Docquity xin gi\u1edbi thi\u1ec7u v\u1edbi qu\u00fd v\u1ecb \u0111\u1ed3ng nghi\u1ec7p b\u1ea3n l\u01b0\u1ee3c d\u1ecbch, \u0111\u1ec1 c\u1eadp \u0111\u1ebfn nh\u1eefng \u0111i\u1ec3m ch\u00ednh quan tr\u1ecdng trong h\u01b0\u1edbng d\u1eabn ki\u1ec3m so\u00e1t s\u1ea3y thai li\u00ean ti\u1ebfp c\u1ee7a RCOG n\u0103m 2023.<\/p>\n\n\n\n<p><strong>Y\u1ebeU T\u1ed0 NGUY C\u01a0 C\u1ee6A S\u1ea2Y THAI LI\u00caN TI\u1ebeP<\/strong><\/p>\n\n\n\n<p><strong>Y\u1ebfu t\u1ed1 d\u1ecbch t\u1ec5<\/strong><\/p>\n\n\n\n<p>Tu\u1ed5i t\u00e1c c\u1ee7a thai ph\u1ee5 c\u00f3 li\u00ean quan \u0111\u1ebfn s\u1ed1 l\u01b0\u1ee3ng v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng suy gi\u1ea3m c\u1ee7a no\u00e3n b\u00e0o, l\u00e0m t\u0103ng nguy c\u01a1 di b\u1ed9i c\u1ee7a ph\u00f4i thai. M\u1ed9t nghi\u00ean c\u1ee9u cho th\u1ea5y nguy c\u01a1 s\u1ea3y thai c\u1ee7a thai ph\u1ee5 theo t\u1eebng nh\u00f3m tu\u1ed5i l\u00e0 13% \u0111\u1ed1i v\u1edbi thai ph\u1ee5 12 \u2013 19 tu\u1ed5i, 11% \u0111\u1ed1i v\u1edbi thai ph\u1ee5 20 \u2013 24 tu\u1ed5i, 12% \u0111\u1ed1i v\u1edbi thai ph\u1ee5 25 \u2013 29 tu\u1ed5i, 15% \u0111\u1ed1i v\u1edbi thai ph\u1ee5 30 \u2013 34 tu\u1ed5i, 25% \u0111\u1ed1i v\u1edbi thai ph\u1ee5 35 \u2013 59 tu\u1ed5i, 51% \u0111\u1ed1i v\u1edbi thai ph\u1ee5 40 \u2013 44 tu\u1ed5i v\u00e0 93% \u0111\u1ed1i v\u1edbi thai ph\u1ee5 \u2265 45 tu\u1ed5i<sup>1<\/sup>. M\u1ed9t ph\u00e2n t\u00edch g\u1ed9p c\u0169ng cho th\u1ea5y t\u1ef7 l\u1ec7 s\u1ea3y thai c\u0169ng t\u0103ng theo khi nam gi\u1edbi \u2265 40 tu\u1ed5i. K\u1ebft qu\u1ea3 m\u1ed9t t\u1ed5ng quan h\u1ec7 th\u1ed1ng cho th\u1ea5y t\u1ef7 l\u1ec7 s\u1ea3y thai \u0111\u1ea1t 11.3%, 17.0%, 28.0%, 39.6%, 47.2% v\u00e0 63.9% \u1edf ph\u1ee5 n\u1eef ch\u01b0a s\u1ea3y thai, s\u1ea3y thai 1 l\u1ea7n, 2 \u2013 3 l\u1ea7n, 4 l\u1ea7n, 5 l\u1ea7n v\u00e0 6 l\u1ea7n. B\u1eb1ng ch\u1ee9ng cho th\u1ea5y kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 ti\u00ean l\u01b0\u1ee3ng s\u1ea3y thai gi\u1eefa thai ph\u1ee5 b\u1ecb s\u1ea3y thai li\u00ean ti\u1ebfp ti\u00ean ph\u00e1t hay th\u1ee9 ph\u00e1t (ph\u1ee5 n\u1eef \u0111\u00e3 sinh con tr\u01b0\u1edbc \u0111\u00f3). Y\u1ebfu t\u1ed1 d\u1ecbch t\u1ec5 v\u1edbi nguy c\u01a1 s\u1ea3y thai li\u00ean ti\u1ebfp \u0111\u01b0\u1ee3c th\u1ec3 hi\u1ec7n trong b\u1ea3ng 1.<\/p>\n\n\n\n<p><strong>B\u1ea3ng 1.<\/strong>&nbsp;Y\u1ebfu t\u1ed1 d\u1ecbch t\u1ec5 v\u00e0 nguy c\u01a1 s\u1ea3y thai<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/s3-ap-southeast-1.amazonaws.com\/bucket.docquity.com\/journals\/editor\/file-7cad164b4ff1448fbb26ea94b495c9e1.png\" alt=\"\" \/><\/figure>\n\n\n\n<p><strong>H\u1ed9i ch\u1ee9ng t\u0103ng \u0111\u00f4ng thrombophilia<\/strong><\/p>\n\n\n\n<p>M\u1ed9t s\u1ed1 \u1ea3nh h\u01b0\u1edfng c\u1ee7a h\u1ed9i ch\u1ee9ng thrombophilia \u0111\u1ebfn k\u1ebft c\u1ee5c c\u1ee7a thai k\u1ef3 bao g\u1ed3m:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u2265 3 \u0111\u1ee3t s\u1ea3y thai li\u00ean ti\u1ebfp tr\u01b0\u1edbc tu\u1ea7n thai th\u1ee9 10<\/li>\n\n\n\n<li>\u2265 1 \u0111\u1ee3t s\u1ea3y thai (thai nhi b\u00ecnh th\u01b0\u1eddng v\u1ec1 m\u1eb7t h\u00ecnh th\u00e1i h\u1ecdc) sau tu\u1ea7n thai th\u1ee9 10<\/li>\n\n\n\n<li>\u2265 1 \u0111\u1ee3t sinh non tr\u01b0\u1edbc tu\u1ea7n thia th\u1ee9 34 v\u00ec b\u1ec7nh nhau thai<\/li>\n<\/ul>\n\n\n\n<p><strong>B\u1ea3ng 2.<\/strong>&nbsp;Thrombophilia v\u00e0 s\u1ea3y thai<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/s3-ap-southeast-1.amazonaws.com\/bucket.docquity.com\/journals\/editor\/file-152eb29fa30cb62dd996c4fb5e301498.png\" alt=\"\" \/><\/figure>\n\n\n\n<p><strong>Y\u1ebfu t\u1ed1 di truy\u1ec1n<\/strong><\/p>\n\n\n\n<p>S\u1ef1 t\u00e1i s\u1eafp x\u1ebfp nhi\u1ec5m s\u1eafc th\u1ec3 c\u1ee7a b\u1ed1 m\u1eb9 c\u00f3 li\u00ean quan \u0111\u1ebfn s\u1ea3y thai li\u00ean ti\u1ebfp. D\u1eef li\u1ec7u cho th\u1ea5y \u0111\u1ed9t bi\u1ebfn chuy\u1ec3n \u0111o\u1ea1n l\u00e0 nguy\u00ean nh\u00e2n c\u1ee7a 2.2% tr\u01b0\u1eddng h\u1ee3p s\u1ea3y thai l\u1ea7n \u0111\u1ea7u, 4.8% tr\u01b0\u1eddng h\u1ee3p s\u1ea3y thai l\u1ea7n 2 v\u00e0 5.7% tr\u01b0\u1eddng h\u1ee3p s\u1ea3y thai l\u1ea7m th\u1ee9 3.<\/p>\n\n\n\n<p>B\u1ea5t th\u01b0\u1eddng v\u1ec1 nhi\u1ec5m s\u1eafc th\u1ec3 trong thai k\u1ef3 l\u00e0 nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn nh\u1ea5t g\u00e2y s\u1ea3y thai. M\u1ed9t b\u00e0i ph\u00e2n t\u00edch cho th\u1ea5y kho\u1ea3ng 50% tr\u01b0\u1eddng h\u1ee3p s\u1ea3y thai. Trong s\u1ed1 nh\u1eefng b\u1ea5t th\u01b0\u1eddng d\u1eabn \u0111\u1ebfn s\u1ea3y thai, \u0111\u1ed9t bi\u1ebfn 3 nhi\u1ec5m s\u1eafc th\u1ec3 chi\u1ebfm 51.9%, hi\u1ec7n t\u01b0\u1ee3ng \u0111a \u0111\u1ed9i chi\u1ebfm 18.8%, m\u1ea5t nhi\u1ec5m s\u1eafc th\u1ec3 chi\u1ebfm 15.2%, b\u1ea5t th\u01b0\u1eddng c\u1ea5u tr\u00fac chi\u1ebfm 6.5% v\u00e0 nguy\u00ean nh\u00e2n kh\u00e1c chi\u1ebfm 7.6%. B\u1ea3ng 3 m\u00f4 t\u1ea3 m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa c\u00e1c y\u1ebfu t\u1ed1 di truy\u1ec1n v\u00e0 s\u1ea3y thai.<\/p>\n\n\n\n<p><strong>B\u1ea3ng 3.<\/strong>&nbsp;Y\u1ebfu t\u1ed1 di truy\u1ec1n v\u00e0 nguy c\u01a1 s\u1ea3y thai<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/s3-ap-southeast-1.amazonaws.com\/bucket.docquity.com\/journals\/editor\/file-855acde218a145385038e3352212bf02.png\" alt=\"\" \/><\/figure>\n\n\n\n<p><strong>Y\u1ebfu t\u1ed1 gi\u1ea3i ph\u1eabu<\/strong><\/p>\n\n\n\n<p>M\u1ed1i li\u00ean h\u1ec7 gi\u1eefa c\u00e1c y\u1ebfu t\u1ed1 gi\u1ea3i ph\u1eabu v\u00e0 nguy c\u01a1 s\u1ea3y thai \u0111\u01b0\u1ee3c th\u1ec3 hi\u1ec7n trong b\u1ea3ng 4.<\/p>\n\n\n\n<p><strong>B\u1ea3ng 4.<\/strong>&nbsp;Y\u1ebfu t\u1ed1 gi\u1ea3i ph\u1eabu v\u00e0 nguy c\u01a1 s\u1ea3y thai<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/s3-ap-southeast-1.amazonaws.com\/bucket.docquity.com\/journals\/editor\/file-9fc97d56b1d19e1c8e0b340086103104.png\" alt=\"\" \/><\/figure>\n\n\n\n<p><strong>N\u1ed9i ti\u1ebft<\/strong><\/p>\n\n\n\n<p>T\u00ecnh tr\u1ea1ng r\u1ed1i lo\u1ea1n n\u1ed9i ti\u1ebft h\u1ec7 th\u1ed1ng \u1edf thai ph\u1ee5 ch\u1eb3ng h\u1ea1n nh\u01b0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng hay b\u1ec7nh tuy\u1ebfn gi\u00e1p c\u00f3 li\u00ean quan \u0111\u1ebfn t\u00ecnh tr\u1ea1ng s\u1ea3y thai. Thai ph\u1ee5 m\u1eafc \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00f3 n\u1ed3ng \u0111\u1ed9 haemoglobin A1c cao \u1edf k\u1ef3 tam c\u00e1 nguy\u00ean th\u1ee9 nh\u1ea5t c\u00f3 nguy c\u01a1 s\u1ea3y thai t\u0103ng v\u00e0 g\u00e2y ra nh\u1eefng b\u1ea5t th\u01b0\u1eddng \u1edf thai nhi. Tuy nhi\u00ean, n\u1ebfu \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t th\u00ec \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng kh\u00f4ng c\u00f2n l\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1 l\u00e0m t\u0103ng s\u1ea3y thai. T\u00ecnh tr\u1ea1ng suy gi\u00e1p kh\u00f4ng tri\u1ec7u ch\u1ee9ng \u0111\u01b0\u1ee3c cho l\u00e0 l\u00e0m t\u0103ng t\u1ef7 l\u1ec7 s\u1ea3y thai li\u00ean t\u1ee5c \u1edf m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u quan s\u00e1t v\u1edbi c\u1ee1 m\u1eabu nh\u1ecf. H\u1ed9i ch\u1ee9ng bu\u1ed3ng tr\u1ee9ng \u0111a nang c\u00f3 li\u00ean quan \u0111\u1ebfn vi\u1ec7c l\u00e0m t\u0103ng nguy c\u01a1 s\u1ea3y thai nh\u01b0ng c\u01a1 ch\u1ebf v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c bi\u1ebft r\u00f5. B\u1ea3ng 5 th\u1ec3 hi\u1ec7n m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa y\u1ebfu t\u1ed1 n\u1ed9i ti\u1ebft v\u00e0 nguy c\u01a1 s\u1ea3y thai.<\/p>\n\n\n\n<p><strong>B\u1ea3ng 5.<\/strong>&nbsp;Y\u1ebfu t\u1ed1 n\u1ed9i ti\u1ebft v\u00e0 nguy c\u01a1 s\u1ea3y thai<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/s3-ap-southeast-1.amazonaws.com\/bucket.docquity.com\/journals\/editor\/file-1377fc17b7a6fe7099f0f7a544c4ec84.png\" alt=\"\" \/><\/figure>\n\n\n\n<p><strong>Y\u1ebfu t\u1ed1 mi\u1ec5n d\u1ecbch<\/strong><\/p>\n\n\n\n<p>Ch\u01b0a c\u00f3 \u0111\u1ee7 b\u1eb1ng ch\u1ee9ng \u0111\u1ec3 \u0111\u01b0a ra k\u1ebft lu\u1eadn v\u1ec1 m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa HLA v\u00e0 s\u1ea3y thai li\u00ean t\u1ee5c. T\u01b0\u01a1ng t\u1ef1 \u0111\u1ed1i v\u1edbi cytokine v\u00e0 t\u1ebf b\u00e0o NK. M\u1ed1i li\u00ean h\u1ec7 gi\u1eefa c\u00e1c y\u1ebfu t\u1ed1 mi\u1ec5n d\u1ecbch v\u00e0 nguy c\u01a1 s\u1ea3y thai \u0111\u01b0\u1ee3c th\u1ec3 hi\u1ec7n trong b\u1ea3ng 6.<\/p>\n\n\n\n<p><strong>B\u1ea3ng 6.<\/strong>&nbsp;Y\u1ebfu t\u1ed1 mi\u1ec5n d\u1ecbch v\u00e0 nguy c\u01a1 s\u1ea3y thai<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/s3-ap-southeast-1.amazonaws.com\/bucket.docquity.com\/journals\/editor\/file-91f1a43e69241e821c749fe78b66404a.png\" alt=\"\" \/><\/figure>\n\n\n\n<p><strong>Y\u1ebfu t\u1ed1 nhi\u1ec5m tr\u00f9ng<\/strong><\/p>\n\n\n\n<p>Nhi\u1ec1u vi sinh v\u1eadt c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn t\u00ecnh tr\u1ea1ng s\u1ea3y thai trong giai \u0111o\u1ea1n tam c\u00e1 nguy\u1ec7t th\u1ee9 nh\u1ea5t v\u00e0 th\u1ee9 hai, bao g\u1ed3m ureaplasma\/mycoplasma. V\u1edbi nh\u1eefng t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh nhi\u1ec5m khu\u1ea9n g\u00f3p m\u1eb7t v\u00e0o c\u01a1 ch\u1ebf b\u1ec7nh sinh c\u1ee7a s\u1ea3y thai, th\u00ec nh\u1eefng vi sinh v\u1eadt n\u00e0y th\u01b0\u1eddng c\u00f3 kh\u1ea3 n\u0103ng hi\u1ec7n di\u1ec7n dai d\u1eb3ng \u1edf \u0111\u01b0\u1eddng ni\u1ec7u \u2013 sinh d\u1ee5c nh\u01b0ng kh\u00f3 ph\u00e1t hi\u1ec7n. Nhi\u1ec5m Toxoplasmosis, rubella, cytomegalovirus, herpes simplex (TORCH) v\u00e0 listeria kh\u00f4ng \u0111\u00e1p \u1ee9ng c\u00e1c ti\u00eau ch\u00ed n\u00e0y, do \u0111\u00f3 kh\u00f4ng x\u00e9t nghi\u1ec7m s\u00e0ng l\u1ecdc TORCH th\u01b0\u1eddng quy. S\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a vi khu\u1ea9n trong \u00e2m \u0111\u1ea1o trong th\u1eddi k\u1ef3 tam c\u00e1 nguy\u1ec7t th\u1ee9 nh\u1ea5t c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a s\u1ea3y thai. Tuy nhi\u00ean b\u1eb1ng ch\u1ee9ng v\u1ec1 m\u1ed1i li\u00ean h\u1ec7 n\u00e0y v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c \u0111\u1ed3ng thu\u1eadn gi\u1eefa c\u00e1c nghi\u00ean c\u1ee9u. H\u01a1n n\u1eefa, d\u1eef li\u1ec7u tr\u00ean ph\u1ee5 n\u1eef b\u1ecb s\u1ea3y thai l\u00e0 ch\u01b0a \u0111\u1ee7. Do \u0111\u00f3 RCOG ch\u01b0a \u0111\u01b0a ra k\u1ebft lu\u1eadn v\u1ec1 m\u1ed1i li\u00ean h\u1ec7 n\u00e0y. B\u1ea3ng 7 th\u1ec3 hi\u1ec7n m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa c\u00e1c y\u1ebfu t\u1ed1 nhi\u1ec5m khu\u1ea9n v\u00e0 nguy c\u01a1 s\u1ea3y thai.<\/p>\n\n\n\n<p><strong>B\u1ea3ng 7.<\/strong>&nbsp;M\u1ed1i li\u00ean h\u1ec7 gi\u1eefa c\u00e1c y\u1ebfu t\u1ed1 nhi\u1ec5m khu\u1ea9n v\u00e0 nguy c\u01a1 s\u1ea3y thai<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/s3-ap-southeast-1.amazonaws.com\/bucket.docquity.com\/journals\/editor\/file-41bbf734056d04045d0d9aee199f0dd3.png\" alt=\"\" \/><\/figure>\n\n\n\n<p><strong>Y\u1ebfu t\u1ed1 li\u00ean quan \u0111\u1ebfn ng\u01b0\u1eddi b\u1ed1<\/strong><\/p>\n\n\n\n<p>M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u cho th\u1ea5y c\u00e1c y\u1ebfu t\u1ed1 li\u00ean quan \u0111\u1ebfn tinh tr\u00f9ng (ch\u1eb3ng h\u1ea1n nh\u01b0 kh\u1ea3 n\u0103ng s\u1ed1ng s\u00f3t, h\u00ecnh th\u00e1i, kh\u1ea3 n\u0103ng di \u0111\u1ed9ng vv) th\u01b0\u1eddng th\u1ea5p h\u01a1n \u1edf nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nam gi\u1edbi t\u1eebng c\u00f3 tr\u1ea3i nghi\u1ec7m s\u1ea3y thai. Tuy nhi\u00ean, d\u1eef li\u1ec7u ch\u01b0a \u0111\u1ea7y \u0111\u1ee7 \u0111\u1ec3 \u0111\u01b0a ra k\u1ebft lu\u1eadn. \u0110\u1ed1i v\u1edbi c\u00e1c ch\u1ec9 s\u1ed1 kh\u00e1c v\u1ec1 DNA c\u1ee7a tinh tr\u00f9ng (ch\u1eb3ng h\u1ea1n nh\u01b0 ph\u00e2n m\u1ea3nh DNA tinh tr\u00f9ng vv) th\u00ec d\u1eef li\u1ec7u s\u1eb5n c\u00f3 h\u01a1n. K\u1ebft qu\u1ea3 m\u1ed9t ph\u00e2n t\u00edch g\u1ed9p cho th\u1ea5y t\u00ecnh tr\u1ea1ng t\u0103ng ph\u00e2n m\u1ea3nh DNA tinh tr\u00f9ng l\u00e0m t\u0103ng nguy c\u01a1 s\u1ea3y thai. M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u cho th\u1ea5y c\u00e1c y\u1ebfu t\u1ed1 li\u00ean quan \u0111\u1ebfn l\u1ed1i s\u1ed1ng c\u00f3 th\u1ec3 \u0111i\u1ec1u ch\u1ec9nh g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 ph\u00e2n m\u1ea3nh DNA tinh tr\u00f9ng nh\u01b0 cai thu\u1ed1c l\u00e1, gi\u1ea3m c\u00e2n\/t\u1eadp th\u1ec3 d\u1ee5c, gi\u1ea3m ph\u01a1i nhi\u1ec5m v\u1edbi kh\u00f4ng kh\u00ed \u00f4 nhi\u1ec5m. M\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 ph\u00e2n m\u1ea3nh DNA c\u00f2n c\u00f3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nhi\u1ec5m tr\u00f9ng, \u0111i\u1ec1u tr\u1ecb \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, \u0111i\u1ec1u tr\u1ecb gi\u00e3n t\u0129nh m\u1ea1ch th\u1eebng tinh, li\u1ec7u ph\u00e1p ch\u1ed1ng oxy h\u00f3a v\u00e0 ch\u1ecdc l\u1ecdc tinh tr\u00f9ng. B\u1ea3ng 8 th\u1ec3 hi\u1ec7n m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa c\u00e1c y\u1ebfu t\u1ed1 li\u00ean quan \u0111\u1ebfn ng\u01b0\u1eddi b\u1ed1 v\u00e0 nguy c\u01a1 s\u1ea3y thai.<\/p>\n\n\n\n<p><strong>B\u1ea3ng 8.<\/strong>&nbsp;C\u00e1c y\u1ebfu t\u1ed1 li\u00ean quan \u0111\u1ebfn ng\u01b0\u1eddi b\u1ed1 v\u00e0 nguy c\u01a1 s\u1ea3y thai<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/s3-ap-southeast-1.amazonaws.com\/bucket.docquity.com\/journals\/editor\/file-0dbc1b71820f49b9f215401a33aa1ac8.png\" alt=\"\" \/><\/figure>\n\n\n\n<p><strong>KHUY\u1ebeN C\u00c1O LI\u00caN QUAN \u0110\u1ebeN S\u00c0NG L\u1eccC, TH\u0102M KH\u00c1M S\u1ea2Y THAI LI\u00caN T\u1ee4C<\/strong><\/p>\n\n\n\n<p><strong>H\u1ed9i ch\u1ee9ng t\u0103ng \u0111\u00f4ng (thrombophilias)<\/strong><\/p>\n\n\n\n<p>\u0110\u1ec3 ch\u1ea9n \u0111o\u00e1n h\u1ed9i ch\u1ee9ng kh\u00e1ng th\u1ec3 kh\u00e1ng phospholipid, RCOG khuy\u1ebfn c\u00e1o b\u1ec7nh nh\u00e2n n\u00ean c\u00f3 2 k\u1ebft qu\u1ea3 x\u00e9t nghi\u00eam d\u01b0\u01a1ng t\u00ednh, c\u00e1ch nhau 12 tu\u1ea7n (v\u00e0 t\u1ed1i thi\u1ec3u 6 tu\u1ea7n sau khi s\u1ea3y thai). B\u1ec7nh nh\u00e2n c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u1ec1 ngh\u1ecb l\u00e0m x\u00e9t nghi\u1ec7m y\u1ebfu t\u1ed1 V Leiden, \u0111\u1ed9t bi\u1ebfn prothrombin gene v\u00e0 thi\u1ebfu h\u1ee5t protein S \u1edf giai \u0111o\u1ea1n tam c\u00e1 nguy\u1ec7t th\u1ee9 2.<\/p>\n\n\n\n<p><strong>B\u1ea3ng 9.<\/strong>&nbsp;Khuy\u1ebfn c\u00e1o ch\u1ea9n \u0111o\u00e1n h\u1ed9i ch\u1ee9ng t\u0103ng \u0111\u00f4ng<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/s3-ap-southeast-1.amazonaws.com\/bucket.docquity.com\/journals\/editor\/file-397f33d39706c8d6c40c426c85a4b37f.png\" alt=\"\" \/><\/figure>\n\n\n\n<p><strong>Di truy\u1ec1n, gi\u1ea3i ph\u1eabu, n\u1ed9i ti\u1ebft, mi\u1ec5n d\u1ecbch, nhi\u1ec5m tr\u00f9ng v\u00e0 y\u1ebfu t\u1ed1 li\u00ean quan \u0111\u1ebfn ng\u01b0\u1eddi b\u1ed1<\/strong><\/p>\n\n\n\n<p><strong>B\u1ea3ng 10.<\/strong>&nbsp;Khuy\u1ebfn c\u00e1o x\u00e9t nghi\u1ec7m cho ph\u1ee5 n\u1eef b\u1ecb s\u1ea3y thai li\u00ean ti\u1ebfp<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/s3-ap-southeast-1.amazonaws.com\/bucket.docquity.com\/journals\/editor\/file-1a8b84ea622962dc59cb5dd0778abb5a.png\" alt=\"\" \/><\/figure>\n\n\n\n<p><strong>L\u1ef0A CH\u1eccN \u0110I\u1ec0U TR\u1eca CHO T\u00ccNH TR\u1ea0NG S\u1ea2Y THAI LI\u00caN TI\u1ebeP<\/strong><\/p>\n\n\n\n<p><strong>B\u1ea3ng 11.<\/strong>&nbsp;Khuy\u1ebfn c\u00e1o \u0111i\u1ec1u tr\u1ecb cho ph\u1ee5 n\u1eef b\u1ecb s\u1ea3y thai li\u00ean ti\u1ebfp<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/s3-ap-southeast-1.amazonaws.com\/bucket.docquity.com\/journals\/editor\/file-ca99780f3d599f3fc9ee7ce54900e746.png\" alt=\"\" \/><\/figure>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\" \/>\n\n\n\n<p><strong>NGU\u1ed2N<\/strong><\/p>\n\n\n\n<p>Regan, L, Rai, R, Saravelos, S, Li, T-C, on behalf of the Royal College of Obstetricians and Gynaecologists. Recurrent Miscarriage: Green-top Guideline No. 17. BJOG. 2023; 130(12): e9\u2013e39. https:\/\/doi.org\/10.1111\/1471-0528.17515<\/p>\n","protected":false},"excerpt":{"rendered":"<p>S\u1ea3y thai li\u00ean ti\u1ebfp \u0111\u01b0\u1ee3c Hi\u1ec7p h\u1ed9i S\u1ea3n Ph\u1ee5 khoa Ho\u00e0ng gia Anh (Royal College of Obstetricians and Gynaecologists \u2013 ROCG) \u0111\u1ecbnh ngh\u0129a l\u00e0 s\u1ea3y thai t\u1eeb 3 l\u1ea7n tr\u1edf l\u00ean v\u00e0o th\u1eddi k\u1ef3 tam c\u00e1 nguy\u1ec7t th\u1ee9 nh\u1ea5t. C\u00f3 kho\u1ea3ng 1% ph\u1ee5 n\u1eef g\u1eb7p ph\u1ea3i t\u00ecnh tr\u1ea1ng s\u1ea3y thai li\u00ean ti\u1ebfp. Nhi\u1ec1u b\u1eb1ng ch\u1ee9ng &hellip;<\/p>\n<p class=\"read-more\"> <a class=\"\" href=\"https:\/\/docquity.com\/vi\/articles\/huong-dan-dieu-tri-cua-rcog-2023-say-thai-lien-tiep\/\"> <span class=\"screen-reader-text\">H\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb c\u1ee7a RCOG 2023: S\u1ea3y thai li\u00ean ti\u1ebfp<\/span> Read More &raquo;<\/a><\/p>\n","protected":false},"author":123,"featured_media":12925,"comment_status":"closed","ping_status":"closed","template":"","meta":{"content-type":"","inline_featured_image":false,"site-sidebar-layout":"default","site-content-layout":"default","ast-global-header-display":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","footnotes":""},"articles_categories":[1370],"articles_tags":[],"articles_topics":[1437],"articles_languages":[1375],"articles_filters":[],"class_list":["post-12924","articles","type-articles","status-publish","has-post-thumbnail","hentry","articles_categories-medical-content-vi","articles_languages-vietnamese-vi"],"_links":{"self":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles\/12924","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles"}],"about":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/types\/articles"}],"author":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/users\/123"}],"replies":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/comments?post=12924"}],"version-history":[{"count":0,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles\/12924\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/media\/12925"}],"wp:attachment":[{"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/media?parent=12924"}],"wp:term":[{"taxonomy":"articles_categories","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_categories?post=12924"},{"taxonomy":"articles_tags","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_tags?post=12924"},{"taxonomy":"articles_topics","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_topics?post=12924"},{"taxonomy":"articles_languages","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_languages?post=12924"},{"taxonomy":"articles_filters","embeddable":true,"href":"https:\/\/docquity.com\/vi\/wp-json\/wp\/v2\/articles_filters?post=12924"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}