{"id":137074,"date":"2025-09-06T15:24:01","date_gmt":"2025-09-06T08:24:01","guid":{"rendered":"https:\/\/vnras.com\/drug\/?p=137074"},"modified":"2025-10-23T10:29:04","modified_gmt":"2025-10-23T03:29:04","slug":"khuyen-cao-esc-2025-ve-quan-ly-benh-ly-tim-mach-o-san-phu","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/khuyen-cao-esc-2025-ve-quan-ly-benh-ly-tim-mach-o-san-phu\/","title":{"rendered":"Khuy\u1ebfn c\u00e1o ESC 2025 v\u1ec1 qu\u1ea3n l\u00fd b\u1ec7nh l\u00fd tim m\u1ea1ch \u1edf s\u1ea3n ph\u1ee5 : c\u1eadp nh\u1eadt v\u00e0 thay \u0111\u1ed5i so v\u1edbi ESC 2018"},"content":{"rendered":"
\"Khuy\u1ebfn
Khuy\u1ebfn c\u00e1o ESC 2025 v\u1ec1 qu\u1ea3n l\u00fd b\u1ec7nh l\u00fd tim m\u1ea1ch \u1edf s\u1ea3n ph\u1ee5: c\u1eadp nh\u1eadt v\u00e0 thay \u0111\u1ed5i so v\u1edbi ESC 2018<\/figcaption><\/figure>\n

Nh\u00f3m bi\u00ean d\u1ecbch:<\/strong><\/p>\n

1. Khoa N\u1ed9i Tim m\u1ea1ch \u2013 Vi\u1ec7n Tim m\u1ea1ch \u2013 B\u1ec7nh vi\u1ec7n Trung \u01b0\u01a1ng Qu\u00e2n \u0111\u1ed9i 108<\/p>\n

2. BS L\u00ea \u0110\u1ea1i Phong \u2013 B\u1ec7nh vi\u1ec7n T\u01afQ\u0110 108<\/p>\n

3. PGS.TS Ph\u1ea1m Tr\u01b0\u1eddng S\u01a1n \u2013 B\u1ec7nh vi\u1ec7n T\u01afQ\u0110 108<\/p>\n

ESC Guidelines for the management of CVD and pregnancy<\/strong><\/p>\n

Authors\/Task Force Members:<\/strong><\/p>\n

Julie De Backer (Task Force Chairperson) (Belgium), Kristina H. Haugaa (Task Force Chairperson) (Norway), Nina Eide Hasselberg (Task Force Coordinator (Norway), Mich\u00e8le de Hosson (Task Force Coordinator) (Belgium), Margarita Brida (Croatia), Silvia Castelletti (Italy), Matthew Cauldwell (United Kingdom) Elisabetta Cerbai (Italy), Lia Crotti (Italy), Natasja M.S. de Groot (Netherlands), Mette-Elise Estensen (Norway), Eva S Goossens (Belgium), Bernhard Haring (Germany), Donata Kurpas (Poland), Carmel M McEniery (United Kingdom), Sanne A.E. Peters (Netherlands), Amina Rakisheva (Kazakhstan), Antonia Sambola (Spain), Oliver Schlager (Austria), Florian S. Schoenhoff (Switzerland), Tommaso Simoncini1 (Italy), Fran\u00e7oise Steinbach (France), Isabella Sudano (Switzerland), Lorna Swan (United Kingdom), Anne Marie Valente (United States of America)<\/p>\n

1<\/sup>Representing the European Society of Gynecology (ESG)<\/p>\n

M\u1ee9c \u0111\u1ed9 khuy\u1ebfn c\u00e1o theo ESC<\/h2>\n
\"M\u1ee9c
M\u1ee9c \u0111\u1ed9 khuy\u1ebfn c\u00e1o theo ESC<\/figcaption><\/figure>\n

M\u1ee9c \u0111\u1ed9 b\u1eb1ng ch\u1ee9ng<\/h2>\n
\"M\u1ee9c
M\u1ee9c \u0111\u1ed9 b\u1eb1ng ch\u1ee9ng<\/figcaption><\/figure>\n

C\u1eadp nh\u1eadt m\u1edbi c\u1ee7a khuy\u1ebfn c\u00e1o 2025<\/h2>\n\n\n\n\n\n\n\n\n\n\n
Topic<\/strong><\/td>\nNew information<\/strong><\/td>\nRationale<\/strong><\/td>\n<\/tr>\n
Nh\u00f3m Tim m\u1ea1ch – thai k\u1ef3<\/td>\n\u0110\u01b0\u1ee3c ch\u1ea5p nh\u1eadn r\u1ed9ng r\u00e3i, c\u00f3 ch\u01b0\u01a1ng ri\u00eang<\/td>\n\u0110\u1ea3m b\u1ea3o ch\u0103m s\u00f3c to\u00e0n di\u1ec7n trong su\u1ed1t c\u00e1c giai \u0111o\u1ea1n sinh s\u1ea3n<\/td>\n<\/tr>\n
Ph\u00e2n t\u1ea7ng nguy c\u01a1<\/td>\nPh\u00e2n lo\u1ea1i mWHO 2.0, chi ti\u1ebft v\u00e0 m\u1edf r\u1ed9ng h\u01a1n<\/td>\nNhi\u1ec1u th\u00f4ng tin h\u01a1n, c\u1ea7n ph\u00e2n t\u1ea7ng nguy c\u01a1 tinh vi h\u01a1n cho t\u01b0 v\u1ea5n<\/td>\n<\/tr>\n
C\u00e1c th\u1eed nghi\u1ec7m v\u00e0 nghi\u00ean c\u1ee9u m\u1edbi<\/td>\nS\u1eed d\u1ee5ng d\u1eef li\u1ec7u ROPAC, PPCM; b\u1ec7nh c\u01a1 tim, h\u1ed9i ch\u1ee9ng r\u1ed1i lo\u1ea1n nh\u1ecbp nguy\u00ean ph\u00e1t.<\/td>\n\u1ee8ng d\u1ee5ng b\u1eb1ng ch\u1ee9ng m\u1edbi nh\u1ea5t v\u00e0o th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng<\/td>\n<\/tr>\n
C\u00e1c t\u00ecnh hu\u1ed1ng l\u00e2m s\u00e0ng<\/td>\nB\u1ed5 sung c\u00e1c thu\u1eadt to\u00e1n x\u1eed tr\u00ed t\u00ecnh hu\u1ed1ng l\u00e2m s\u00e0ng \u1edf ph\u1ee5 n\u1eef mang thai.<\/td>\nCung c\u1ea5p th\u00f4ng tin th\u1ef1c h\u00e0nh cho b\u00e1c s\u0129 tim m\u1ea1ch<\/td>\n<\/tr>\n
X\u00e9t nghi\u1ec7m gene v\u00e0 t\u01b0 v\u1ea5n<\/td>\nTi\u1ebfn b\u1ed9 trong x\u00e9t nghi\u1ec7m v\u00e0 ch\u1ea9n \u0111o\u00e1n ti\u1ec1n l\u00e0m t\u1ed5<\/td>\nC\u1eadp nh\u1eadt l\u1ef1a ch\u1ecdn m\u1edbi trong qu\u1ea3n l\u00fd<\/td>\n<\/tr>\n
\u0110i\u1ec1u ch\u1ec9nh ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh (COR III) \u0111\u1ed1i v\u1edbi mang thai \u1edf ph\u1ee5 n\u1eef \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i mWHO l\u1edbp IV<\/td>\nNh\u1ea5n m\u1ea1nh vai tr\u00f2 then ch\u1ed1t c\u1ee7a vi\u1ec7c t\u01b0 v\u1ea5n to\u00e0n di\u1ec7n b\u1edfi Nh\u00f3m Tim m\u1ea1ch \u2013 Thai k\u1ef3<\/td>\nTh\u1eeba nh\u1eadn quy\u1ec1n t\u1ef1 ch\u1ee7 c\u1ee7a ng\u01b0\u1eddi ph\u1ee5 n\u1eef trong vi\u1ec7c \u0111\u01b0a ra l\u1ef1a ch\u1ecdn sinh s\u1ea3n. Khuy\u1ebfn kh\u00edch \u0111\u1ed1i tho\u1ea1i chi ti\u1ebft v\u00e0 minh b\u1ea1ch v\u1ec1 c\u00e1c nguy c\u01a1 gia t\u0103ng, \u0111\u1ed3ng th\u1eddi th\u00fac \u0111\u1ea9y vi\u1ec7c ra quy\u1ebft \u0111\u1ecbnh chung<\/td>\n<\/tr>\n
Bi\u1ebfn c\u1ed1 thai k\u1ef3 b\u1ea5t l\u1ee3i (APO)<\/td>\nT\u1eadp trung nhi\u1ec1u h\u01a1n v\u00e0o c\u00e1c k\u1ebft c\u1ee5c l\u00e2u d\u00e0i<\/td>\nB\u1eb1ng ch\u1ee9ng \u1ee7ng h\u1ed9 s\u1ef1 c\u1ea7n thi\u1ebft c\u1ee7a th\u1ea3o lu\u1eadn k\u1ef9 l\u01b0\u1ee1ng v\u00e0 qu\u1ea3n l\u00fd APOs<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\"H\u00ecnh
H\u00ecnh 1. Vai tr\u00f2 c\u1ee7a Nh\u00f3m Tim m\u1ea1ch Thai k\u1ef3 xuy\u00ean su\u1ed1t qu\u00e1 tr\u00ecnh sinh s\u1ea3n<\/figcaption><\/figure>\n

Khuy\u1ebfn c\u00e1o m\u1edbi (1)<\/h2>\n\n\n\n\n\n\n\n\n
Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
Section 4. Pregnancy Heart Team<\/strong><\/td>\n<\/tr>\n
M\u1eb7c d\u00f9 kh\u00e1i ni\u1ec7m Pregnancy Heart Team tr\u01b0\u1edbc \u0111\u00e2y ch\u1ec9 l\u00e0 m\u1ed9t ph\u1ea7n trong c\u00e1c nguy\u00ean t\u1eafc chung, nh\u01b0ng nay \u0111\u00e3 c\u00f3 m\u1ed9t m\u1ee5c ri\u00eang, bao qu\u00e1t t\u1ea5t c\u1ea3 c\u00e1c giai \u0111o\u1ea1n t\u1eeb tr\u01b0\u1edbc th\u1ee5 thai \u0111\u1ebfn h\u1eadu s\u1ea3n<\/td>\n<\/tr>\n
Th\u1ea3o lu\u1eadn b\u1edfi Pregnancy Heart Team v\u1ec1 nguy c\u01a1 t\u1eed vong ho\u1eb7c b\u1ec7nh su\u1ea5t m\u1eb9 cao v\u00e0 nguy c\u01a1 thai cao li\u00ean quan \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o cho ph\u1ee5 n\u1eef c\u00f3 t\u00ecnh tr\u1ea1ng thu\u1ed9c mWHO 2.0 l\u1edbp IV, bao g\u1ed3m quy tr\u00ecnh ra quy\u1ebft \u0111\u1ecbnh chung v\u1ec1 \u0111\u00ecnh ch\u1ec9 thai k\u1ef3, c\u00f3 s\u1ef1 tham gia h\u1ed7 tr\u1ee3 t\u00e2m l\u00fd<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o r\u1eb1ng ph\u1ee5 n\u1eef c\u00f3 CVD thu\u1ed9c mWHO 2.0 l\u1edbp II\u2013III tr\u1edf l\u00ean c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 v\u00e0 qu\u1ea3n l\u00fd b\u1edfi Pregnancy Heart Team t\u1eeb tr\u01b0\u1edbc khi mang thai cho \u0111\u1ebfn khi sinh v\u00e0 h\u1eadu s\u1ea3n<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
\u0110o BNP v\u00e0 NT-proBNP n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc tr\u01b0\u1edbc thai k\u1ef3 \u1edf ph\u1ee5 n\u1eef HF do b\u1ea5t k\u1ef3 nguy\u00ean nh\u00e2n n\u00e0o, bao g\u1ed3m PPCM tr\u01b0\u1edbc \u0111\u00f3, b\u1ec7nh c\u01a1 tim, ACHD v\u00e0 PAH, \u0111\u1ed3ng th\u1eddi \u0111\u01b0\u1ee3c theo d\u00f5i trong thai k\u1ef3 t\u00f9y theo b\u1ec7nh n\u1ec1n v\u00e0 khi xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng m\u1edbi ho\u1eb7c n\u1eb7ng l\u00ean<\/td>\nIIa<\/td>\nB<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Khuy\u1ebfn c\u00e1o m\u1edbi (2)<\/h2>\n\n\n\n\n\n\n\n\n\n
Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
Section 5. Thu\u1ed1c trong th\u1eddi k\u00ec mang thai v\u00e0 cho con b\u00fa<\/strong><\/td>\n<\/tr>\n
M\u1eb7c d\u00f9 kh\u00e1i ni\u1ec7m s\u1eed d\u1ee5ng thu\u1ed1c \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ea3o lu\u1eadn xuy\u00ean su\u1ed1t, nh\u01b0ng m\u1ee5c n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u01b0a ra ph\u00eda tr\u01b0\u1edbc v\u00e0 ch\u1ec9nh s\u1eeda<\/td>\n<\/tr>\n
Section 6. Ph\u1ee5 n\u1eef c\u00f3 thai v\u1edbi b\u1ec7nh l\u00fd c\u01a1 tim v\u00e0 h\u1ed9i ch\u1ee9ng r\u1ed1i lo\u1ea1n nh\u1ecbp nguy\u00ean ph\u00e1t<\/strong><\/td>\n<\/tr>\n
M\u1ee5c n\u00e0y \u0111\u00e3 \u0111\u01b0\u1ee3c m\u1edf r\u1ed9ng do c\u00f3 nhi\u1ec1u d\u1eef li\u1ec7u h\u01a1n trong m\u1ed9t s\u1ed1 b\u1ec7nh c\u01a1 tim v\u00e0 r\u1ed1i lo\u1ea1n nh\u1ecbp nguy\u00ean ph\u00e1t<\/td>\n<\/tr>\n
\u0110\u1ebb th\u01b0\u1eddng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u1edf h\u1ea7u h\u1ebft ph\u1ee5 n\u1eef m\u1eafc b\u1ec7nh l\u00fd c\u01a1 tim, tr\u1eeb khi c\u00f3 ch\u1ec9 \u0111\u1ecbnh s\u1ea3n khoa cho m\u1ed5 l\u1ea5y thai, suy tim n\u1eb7ng (EF <30% v\u00e0\/ho\u1eb7c NYHA III\/IV), lo\u1ea1n nh\u1ecbp kh\u00f4ng ki\u1ec3m so\u00e1t, t\u1eafc ngh\u1ebdn LVOT n\u1eb7ng (\u226550 mmHg), ho\u1eb7c chuy\u1ec3n d\u1ea1 khi \u0111ang d\u00f9ng VKA.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
\u1ede ph\u1ee5 n\u1eef c\u00f3 b\u1ec7nh c\u01a1 tim th\u1ec3 gi\u00e3n c\u00f3 ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i x\u1ea5u \u0111i trong thai k\u1ef3, khuy\u1ebfn c\u00e1o t\u01b0 v\u1ea5n nguy c\u01a1 t\u00e1i ph\u00e1t trong c\u00e1c thai k\u1ef3 sau trong m\u1ecdi tr\u01b0\u1eddng h\u1ee3p, ngay c\u1ea3 khi ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i \u0111\u00e3 h\u1ed3i ph\u1ee5c<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Khuy\u1ebfn c\u00e1o m\u1edbi (3)<\/h2>\n\n\n\n\n\n\n\n\n\n\n
Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
Section 6. Ph\u1ee5 n\u1eef c\u00f3 thai v\u1edbi b\u1ec7nh l\u00fd c\u01a1 tim v\u00e0 h\u1ed9i ch\u1ee9ng r\u1ed1i lo\u1ea1n nh\u1ecbp nguy\u00ean ph\u00e1t (ti\u1ebfp)<\/strong><\/td>\n<\/tr>\n
(Khuy\u1ebfn c\u00e1o r\u1eb1ng ph\u1ee5 n\u1eef c\u00f3 HCM v\u1edbi r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng LV c\u00f3 tri\u1ec7u ch\u1ee9ng (EF <50%) v\u00e0\/ho\u1eb7c LVOTO n\u1eb7ng (\u226550 mmHg) ph\u1ea3i \u0111\u01b0\u1ee3c Pregnancy Heart Team t\u01b0 v\u1ea5n v\u1ec1 nguy c\u01a1 cao c\u1ee7a c\u00e1c bi\u1ebfn c\u1ed1 li\u00ean quan \u0111\u1ebfn thai k\u1ef3<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Thu\u1ed1c \u1ee9c ch\u1ebf myosin kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng trong thai k\u1ef3 do thi\u1ebfu d\u1eef li\u1ec7u an to\u00e0n.<\/td>\nIII<\/td>\nC<\/td>\n<\/tr>\n
Thu\u1ed1c ch\u1eb9n beta, d\u00f9ng li\u1ec1u nh\u01b0 tr\u01b0\u1edbc thai k\u1ef3, v\u1edbi nadolol v\u00e0 propranolol l\u00e0 thu\u1ed1c l\u1ef1a ch\u1ecdn, \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o trong thai k\u1ef3 v\u00e0 \u1edf ph\u1ee5 n\u1eef c\u00f3 LQTS<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb beta-blocker trong th\u1eddi k\u1ef3 cho con b\u00fa \u1edf ph\u1ee5 n\u1eef LQTS \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 lo\u1ea1n nh\u1ecbp<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
Thu\u1ed1c ch\u1eb9n beta li\u1ec1u tr\u01b0\u1edbc thai k\u1ef3 v\u1edbi nadolol ho\u1eb7c propranolol \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u1edf b\u1ec7nh nh\u00e2n LQT2, \u0111\u1eb7c bi\u1ec7t trong giai \u0111o\u1ea1n h\u1eadu s\u1ea3n \u2013 th\u1eddi k\u1ef3 nguy c\u01a1 cao x\u1ea3y ra lo\u1ea1n nh\u1ecbp \u0111e d\u1ecda t\u00ednh m\u1ea1ng<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
Thu\u1ed1c ch\u1eb9n beta, li\u1ec1u tr\u01b0\u1edbc thai k\u1ef3 v\u00e0 v\u1edbi nadolol, propranolol l\u00e0 l\u1ef1a ch\u1ecdn \u01b0u ti\u00ean, \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o trong thai k\u1ef3 v\u00e0 cho con b\u00fa \u1edf ph\u1ee5 n\u1eef c\u00f3 CPVT<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Khuy\u1ebfn c\u00e1o m\u1edbi (4)<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n
Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
Section 6. Ph\u1ee5 n\u1eef c\u00f3 thai v\u1edbi b\u1ec7nh l\u00fd c\u01a1 tim v\u00e0 h\u1ed9i ch\u1ee9ng r\u1ed1i lo\u1ea1n nh\u1ecbp nguy\u00ean ph\u00e1t (ti\u1ebfp)<\/strong><\/td>\n<\/tr>\n
Flecainide, ph\u1ed1i h\u1ee3p v\u1edbi beta-blocker, \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u1edf ph\u1ee5 n\u1eef CPVT c\u00f3 bi\u1ebfn c\u1ed1 tim nh\u01b0 ng\u1ea5t, VT ho\u1eb7c ng\u1eebng tim trong thai k\u1ef3<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Section 7. Peripartum cardiomyopathy<\/strong><\/td>\n<\/tr>\n
(Trong khuy\u1ebfn c\u00e1o n\u00e0y \u0111\u00e3 c\u00f3 m\u1ed9t m\u1ee5c ri\u00eang v\u1ec1 PPCM<\/td>\n<\/tr>\n
N\u00ean c\u00e2n nh\u1eafc \u0111\u00e1nh gi\u00e1 v\u00e0 x\u00e9t nghi\u1ec7m di truy\u1ec1n \u1edf ph\u1ee5 n\u1eef PPCM<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
Ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb HF n\u1ebfu HF c\u00f2n t\u1ed3n t\u1ea1i ho\u1eb7c theo h\u01b0\u1edbng d\u1eabn AHA HF, n\u00ean duy tr\u00ec \u00edt nh\u1ea5t 12 th\u00e1ng sau khi LV h\u1ed3i ph\u1ee5c ho\u00e0n to\u00e0n \u2013 th\u1ec3 t\u00edch v\u00e0 ch\u1ee9c n\u0103ng LV b\u00ecnh th\u01b0\u1eddng<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
Section 8. Ph\u1ee5 n\u1eef c\u00f3 thai v\u1edbi b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/strong><\/td>\n<\/tr>\n
T\u1eeb n\u0103m 2018, \u0111\u00e3 c\u00f3 nhi\u1ec1u b\u1eb1ng ch\u1ee9ng m\u1edbi v\u1ec1 b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 ng\u1ef1c di truy\u1ec1n (HTAD), v\u00ec v\u1eady m\u1ed9t m\u1ee5c ri\u00eang v\u1ec1 ph\u1ee5 n\u1eef c\u00f3 b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u0111\u00e3 \u0111\u01b0\u1ee3c b\u1ed5 sung v\u00e0o khuy\u1ebfn c\u00e1o<\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o ph\u1ee5 n\u1eef c\u00f3 ti\u1ec1n s\u1eed b\u00f3c t\u00e1ch ho\u1eb7c ph\u1eabu thu\u1eadt \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 ph\u1ea3i \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n tr\u01b0\u1edbc khi mang thai v\u1ec1 nguy c\u01a1 r\u1ea5t cao, b\u1edfi Pregnancy Heart Team m\u1edf r\u1ed9ng, c\u00e2n nh\u1eafc s\u1ef1 hi\u1ec7n di\u1ec7n v\u00e0 lo\u1ea1i bi\u1ebfn th\u1ec3 gen, h\u00ecnh th\u00e1i, t\u1ed1c \u0111\u1ed9 ph\u00e1t tri\u1ec3n v\u00e0 c\u0103n nguy\u00ean b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Khuy\u1ebfn c\u00e1o m\u1edbi (5)<\/h2>\n\n\n\n\n\n\n\n\n\n
Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
Section 9. Ph\u1ee5 n\u1eef c\u00f3 thai \u0111\u00e3 ph\u00e1t hi\u1ec7n b\u1ec7nh l\u00fd tim c\u1ea5u tr\u00fac tr\u01b0\u1edbc \u0111\u00e2y<\/strong><\/td>\n<\/tr>\n
T\u1eeb n\u0103m 2018, \u0111\u00e3 c\u00f3 th\u00eam nhi\u1ec1u b\u1eb1ng ch\u1ee9ng t\u1eeb c\u00e1c b\u00e1o c\u00e1o g\u1ea7n \u0111\u00e2y, \u0111\u00e3 \u0111\u01b0\u1ee3c t\u00f3m t\u1eaft r\u00f5 r\u00e0ng v\u00e0 s\u00fac t\u00edch trong b\u1ea3ng.<\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o r\u1eb1ng ph\u1ee5 n\u1eef c\u00f3 tu\u1ea7n ho\u00e0n Fontan mu\u1ed1n mang thai ph\u1ea3i \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n b\u1edfi Pregnancy Heart Team v\u1ec1 nguy c\u01a1 cao c\u1ee7a bi\u1ebfn c\u1ed1 li\u00ean quan \u0111\u1ebfn thai k\u1ef3<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Section 10. Ph\u1ee5 n\u1eef c\u00f3 thai v\u1edbi t\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i<\/strong><\/td>\n<\/tr>\n
Ch\u1ee7 \u0111\u1ec1 n\u00e0y hi\u1ec7n \u0111\u01b0\u1ee3c \u0111\u1ec1 c\u1eadp trong m\u1ed9t m\u1ee5c ri\u00eang c\u1ee7a khuy\u1ebfn c\u00e1o, ph\u00f9 h\u1ee3p v\u1edbi s\u1ef1 hi\u1ec3u bi\u1ebft ng\u00e0y c\u00e0ng t\u0103ng v\u1ec1 t\u00ecnh tr\u1ea1ng nguy c\u01a1 cao n\u00e0y<\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o ph\u1ee5 n\u1eef \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n PAH n\u1ebfu mu\u1ed1n mang thai ph\u1ea3i \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n b\u1edfi nh\u00f3m \u0111a chuy\u00ean khoa v\u1ec1 nguy c\u01a1 r\u1ea5t cao c\u1ee7a bi\u1ebfn c\u1ed1 thai k\u1ef3, \u0111\u1ed3ng th\u1eddi khuy\u1ebfn kh\u00edch qu\u00e1 tr\u00ecnh ra quy\u1ebft \u0111\u1ecbnh chung v\u1ec1 vi\u1ec7c c\u00f3 n\u00ean mang thai hay kh\u00f4ng<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Khuy\u1ebfn c\u00e1o m\u1edbi (6)<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n
Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
Section 11. Huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch trong v\u00e0 sau mang thai<\/strong><\/td>\n<\/tr>\n
H\u01b0\u1edbng d\u1eabn v\u1ec1 s\u1ef1 tham gia c\u1ee7a nh\u00f3m chuy\u00ean gia v\u00e0 vi\u1ec7c kh\u1edfi tr\u1ecb nhanh h\u01a1n hi\u1ec7n \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o s\u01a1 \u0111\u1ed3 v\u00e0 khuy\u1ebfn c\u00e1o ri\u00eang.<\/td>\n<\/tr>\n
\u1ede ph\u1ee5 n\u1eef mang thai ho\u1eb7c h\u1eadu s\u1ea3n nghi ng\u1edd VTE (DVT v\u00e0\/ho\u1eb7c PE), khuy\u1ebfn c\u00e1o th\u1ef1c hi\u1ec7n ch\u1ea9n \u0111o\u00e1n ngay l\u1eadp t\u1ee9c b\u1eb1ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p chu\u1ea9n, kh\u00f4ng \u0111\u01b0\u1ee3c tr\u00ec ho\u00e3n<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
Section 12. Ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 b\u1ec7nh tim m\u1ea1ch m\u1eafc ph\u1ea3i<\/strong><\/td>\n<\/tr>\n
C\u00e1c khuy\u1ebfn ngh\u1ecb cho c\u00e1c t\u00ecnh hu\u1ed1ng kh\u1ea9n c\u1ea5p \u0111\u01b0\u1ee3c cung c\u1ea5p cho c\u00e1c b\u1ec7nh tim m\u1eafc ph\u1ea3i ngo\u00e0i c\u00e1c ph\u1ea7n m\u1edbi v\u1ec1 tim m\u1ea1ch-ung th\u01b0 v\u00e0 gh\u00e9p tim<\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o v\u1ec1 ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 b\u1ec7nh m\u1ea1ch v\u00e0nh<\/strong><\/td>\n<\/tr>\n
\u1ede ph\u1ee5 n\u1eef mang thai ho\u1eb7c h\u1eadu s\u1ea3n nghi ng\u1edd VTE (DVT v\u00e0\/ho\u1eb7c PE), khuy\u1ebfn c\u00e1o th\u1ef1c hi\u1ec7n ch\u1ea9n \u0111o\u00e1n ngay l\u1eadp t\u1ee9c b\u1eb1ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p chu\u1ea9n, kh\u00f4ng \u0111\u01b0\u1ee3c tr\u00ec ho\u00e3n<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Th\u1eddi gian DAPT (aspirin + clopidogrel) \u1edf ph\u1ee5 n\u1eef mang thai \u0111\u1eb7t stent \u0110MV \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o t\u01b0\u01a1ng t\u1ef1 nh\u01b0 \u1edf ph\u1ee5 n\u1eef kh\u00f4ng mang thai, nh\u01b0ng ph\u1ea3i c\u00e1 th\u1ec3 h\u00f3a theo nguy c\u01a1 thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 v\u00e0 nguy c\u01a1 ch\u1ea3y m\u00e1u khi sinh.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
C\u00f3 th\u1ec3 c\u00e2n nh\u1eafc ti\u1ebfp t\u1ee5c statin trong thai k\u1ef3 \u1edf ph\u1ee5 n\u1eef \u0111\u00e3 c\u00f3 ASCVD<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Khuy\u1ebfn c\u00e1o m\u1edbi (7)<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n
Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
Section 12. Ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 b\u1ec7nh tim m\u1ea1ch m\u1eafc ph\u1ea3i (ti\u1ebfp).<\/strong><\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o v\u1ec1 ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 t\u0103ng huy\u1ebft \u00e1p<\/strong><\/td>\n<\/tr>\n
(Khuy\u1ebfn c\u00e1o huy\u1ebft \u00e1p m\u1ee5c ti\u00eau \u1edf ph\u1ee5 n\u1eef mang thai: HATT <140 mmHg v\u00e0 HATTr <90 mmHg<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
\u1ede THA n\u1eb7ng, khuy\u1ebfn c\u00e1o d\u00f9ng i.v. labetalol, urapidil, nicardipine, ho\u1eb7c nifedipine ng\u1eafn h\u1ea1n \u0111\u01b0\u1eddng u\u1ed1ng, ho\u1eb7c methyldopa \u0111\u1ec3 h\u1ea1 HA c\u1ea5p. Hydralazine l\u00e0 l\u1ef1a ch\u1ecdn h\u00e0ng hai<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o v\u1ec1 ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 c\u01a1n nh\u1ecbp nhanh k\u1ecbch ph\u00e1t tr\u00ean th\u1ea5t<\/strong><\/td>\n<\/tr>\n
\u1ede ph\u1ee5 n\u1eef mang thai c\u00f3 AF v\u00e0 nguy c\u01a1 thuy\u00ean t\u1eafc cao, khuy\u1ebfn c\u00e1o ch\u1ed1ng \u0111\u00f4ng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng LMWH<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Flecainide k\u1ebft h\u1ee3p beta-blocker n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc cho ki\u1ec3m so\u00e1t nh\u1ecbp l\u00e2u d\u00e0i \u1edf AF<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o v\u1ec1 ph\u1ee5 n\u1eef c\u00f3 thai v\u1edbi c\u01a1n nhanh th\u1ea5t, c\u1ea5y m\u00e1y, v\u00e0 tri\u1ec7t \u0111\u1ed1t<\/strong><\/td>\n<\/tr>\n
Tri\u1ec7t \u0111\u1ed1t catheter \u1edf ph\u1ee5 n\u1eef mang thai ch\u1ecdn l\u1ecdc: n\u00ean c\u00e2n nh\u1eafc d\u00f9ng h\u1ec7 th\u1ed1ng l\u1eadp b\u1ea3n \u0111\u1ed3 v\u00e0 d\u1eabn \u0111\u01b0\u1eddng kh\u00f4ng b\u1ee9c x\u1ea1<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Khuy\u1ebfn c\u00e1o m\u1edbi (8)<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n
Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
Section 12. Ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 b\u1ec7nh tim m\u1ea1ch m\u1eafc ph\u1ea3i (ti\u1ebfp).<\/strong><\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o v\u1ec1 ng\u1eebng tim \u1edf ph\u1ee5 n\u1eef c\u00f3 thai<\/strong><\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o d\u1ecbch chuy\u1ec3n t\u1eed cung sang tr\u00e1i b\u1eb1ng tay li\u00ean t\u1ee5c khi CPR \u1edf ph\u1ee5 n\u1eef mang thai \u2265 20 tu\u1ea7n<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
N\u1ebfu ng\u1eebng tim \u1edf thai \u226520 tu\u1ea7n, khuy\u1ebfn c\u00e1o m\u1ed5 l\u1ea5y thai h\u1ed3i s\u1ee9c trong v\u00f2ng 5 ph\u00fat d\u01b0\u1edbi c\u01a1 ho\u00e0nh \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o \u00e9p tim kh\u00f4ng b\u1ecb c\u1ea3n b\u1edfi t\u1eed cung c\u00f3 thai<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Ng\u01b0\u1eddi ta khuy\u1ebfn c\u00e1o kh\u00f4ng n\u00ean ng\u1eebng thu\u1ed1c \u1edf ph\u1ee5 n\u1eef mang thai b\u1ecb ng\u1eebng tim v\u00ec lo ng\u1ea1i v\u1ec1 kh\u1ea3 n\u0103ng g\u00e2y qu\u00e1i thai.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o v\u1ec1 block nh\u0129 th\u1ea5t b\u1ea9m sinh \u1edf ph\u1ee5 n\u1eef c\u00f3 thai<\/strong><\/td>\n<\/tr>\n
(\u1ede ph\u1ee5 n\u1eef mang thai c\u00f3 block nh\u0129-th\u1ea5t b\u1ea9m sinh v\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1 (QT d\u00e0i, b\u1ea5t th\u01b0\u1eddng gi\u1ea3i ph\u1eabu tim, QRS r\u1ed9ng, nh\u1ecbp ch\u1eadm, t\u1ea7n s\u1ed1 th\u1ea5t \u226450 bpm), n\u00ean c\u00e2n nh\u1eafc \u0111\u1eb7t m\u00e1y t\u1ea1o nh\u1ecbp d\u1ef1 ph\u00f2ng<\/td>\nIII<\/td>\nC<\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o v\u1ec1 ban sinh h\u1ecdc \u1edf ph\u1ee5 n\u1eef c\u00f3 thai<\/strong><\/td>\n<\/tr>\n
Ph\u1eabu thu\u1eadt van tim trong th\u1eddi k\u1ef3 mang thai ch\u1ec9 n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc khi c\u00f3 nguy c\u01a1 t\u1eed vong \u1edf b\u00e0 m\u1eb9 v\u00e0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1c kh\u00f4ng hi\u1ec7u qu\u1ea3.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Khuy\u1ebfn c\u00e1o m\u1edbi (9)<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n
Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
Section 12. Ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 b\u1ec7nh tim m\u1ea1ch m\u1eafc ph\u1ea3i (ti\u1ebfp).<\/strong><\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o cho b\u1ec7nh van nh\u00e2n t\u1ea1o v\u00e0 thai k\u1ef3<\/strong><\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o l\u1eadp k\u1ebf ho\u1ea1ch ch\u0103m s\u00f3c, ghi nh\u1eadn chi\u1ebfn l\u01b0\u1ee3c ch\u1ed1ng \u0111\u00f4ng \u0111\u00e3 th\u1ed1ng nh\u1ea5t (bao g\u1ed3m giai \u0111o\u1ea1n d\u00f9ng VKA ho\u1eb7c chuy\u1ec3n sang LMWH li\u1ec1u \u0111i\u1ec1u tr\u1ecb trong tam c\u00e1 nguy\u1ec7t \u0111\u1ea7u) cho ph\u1ee5 n\u1eef c\u00f3 MHV tr\u01b0\u1edbc khi mang thai ho\u1eb7c ngay khi c\u00f3 thai<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o v\u1ec1 block nh\u0129 th\u1ea5t b\u1ea9m sinh \u1edf ph\u1ee5 n\u1eef c\u00f3 thai<\/strong><\/td>\n<\/tr>\n
Thu\u1ed1c t\u0103ng co b\u00f3p c\u01a1 tim v\u00e0\/ho\u1eb7c thu\u1ed1c l\u00e0m co m\u1ea1ch \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef mang thai b\u1ecb s\u1ed1c tim, trong \u0111\u00f3 levosimendan, dobutamine v\u00e0 milrinone l\u00e0 nh\u1eefng thu\u1ed1c \u0111\u01b0\u1ee3c<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
ACE-Is, ARBs, ARNI, MRA, ivabradine, SGLT2i kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o trong thai k\u1ef3 do nguy c\u01a1 qu\u00e1i thai<\/td>\nIII<\/td>\nC<\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o v\u1ec1 gh\u00e9p tim \u1edf ph\u1ee5 n\u1eef c\u00f3 thai<\/strong><\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o ho\u00e3n mang thai \u00edt nh\u1ea5t 1 n\u0103m sau gh\u00e9p tim, c\u00f3 t\u00ednh \u0111\u1ebfn y\u1ebfu t\u1ed1 nguy c\u01a1 c\u00e1 th\u1ec3.)<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o theo d\u00f5i n\u1ed3ng \u0111\u1ed9 thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch \u0111\u1ecbnh k\u1ef3 (m\u1ed7i 4 tu\u1ea7n \u0111\u1ebfn tu\u1ea7n 32, m\u1ed7i 2 tu\u1ea7n \u0111\u1ebfn tu\u1ea7n 36, sau \u0111\u00f3 h\u00e0ng tu\u1ea7n \u0111\u1ebfn khi sinh, v\u00e0 trong 6\u201312 th\u00e1ng sau sinh \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Khuy\u1ebfn c\u00e1o m\u1edbi (10)<\/h2>\n\n\n\n\n\n\n\n\n\n
Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
Section 12. Ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 b\u1ec7nh tim m\u1ea1ch m\u1eafc ph\u1ea3i (ti\u1ebfp).<\/strong><\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o v\u1ec1 tim m\u1ea1ch v\u00e0 ung th\u01b0 v\u00e0 thai k\u1ef3<\/strong><\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o r\u1eb1ng ph\u1ee5 n\u1eef mang thai m\u1eafc ung th\u01b0 c\u1ea7n h\u00f3a tr\u1ecb c\u00f3 \u0111\u1ed9c t\u00ednh tim n\u00ean \u0111\u01b0\u1ee3c qu\u1ea3n l\u00fd ph\u1ed1i h\u1ee3p b\u1edfi Nh\u00f3m Tim m\u1ea1ch Thai k\u1ef3 (Pregnancy Heart Team) v\u00e0 Nh\u00f3m Tim m\u1ea1ch\u2013Ung th\u01b0 (cardio-oncology team).<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Section 13. T\u00e1c \u0111\u1ed9ng l\u00e2u d\u00e0i c\u1ee7a k\u1ebft qu\u1ea3 thai k\u1ef3 b\u1ea5t l\u1ee3i<\/strong><\/td>\n<\/tr>\n
\u0110\u00e2y l\u00e0 m\u1ed9t m\u1ee5c ho\u00e0n to\u00e0n m\u1edbi trong khuy\u1ebfn c\u00e1o, ph\u1ea3n \u00e1nh s\u1ef1 th\u1eeba nh\u1eadn ng\u00e0y c\u00e0ng t\u0103ng v\u1ec1 t\u1ea7m quan tr\u1ecdng c\u1ee7a APO<\/td>\n<\/tr>\n
Khuy\u1ebfn c\u00e1o \u0111\u00e1nh gi\u00e1 nguy c\u01a1 tim m\u1ea1ch \u1edf ph\u1ee5 n\u1eef c\u00f3 APO, ghi nh\u1eadn APO khi t\u00ednh to\u00e1n nguy c\u01a1 CVD, v\u00e0 t\u01b0 v\u1ea5n v\u1ec1 t\u1ea7m quan tr\u1ecdng c\u1ee7a l\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh nh\u1eb1m t\u1ed1i \u01b0u s\u1ee9c kh\u1ecfe tim m\u1ea1ch.<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Thay \u0111\u1ed5i khuy\u1ebfn c\u00e1o (1)<\/h2>\n\n\n\n\n\n\n\n
2018 Guidelines<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n2025 Guidelines<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
Section 4. The Pregnancy Heart Team<\/strong><\/td>\n<\/tr>\n
Kh\u00e1ng sinh d\u1ef1 ph\u00f2ng \u0111\u1ec3 ph\u00f2ng vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c trong khi sinh kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o<\/td>\nIII<\/td>\nC<\/td>\nC\u00f3 th\u1ec3 c\u00e2n nh\u1eafc d\u00f9ng kh\u00e1ng sinh d\u1ef1 ph\u00f2ng to\u00e0n th\u00e2n trong khi sinh \u1edf ph\u1ee5 n\u1eef nguy c\u01a1 cao.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n
Section 6. Khuy\u1ebfn c\u00e1o v\u1ec1 b\u1ec7nh l\u00fd c\u01a1 tim \u1edf ph\u1ee5 n\u1eef c\u00f3 thai<\/strong><\/td>\n<\/tr>\n
\u1ede b\u1ec7nh nh\u00e2n HCM, khuy\u1ebfn c\u00e1o ti\u1ebfp t\u1ee5c beta-blocker \u1edf ph\u1ee5 n\u1eef \u0111\u00e3 d\u00f9ng tr\u01b0\u1edbc khi mang thai<\/td>\nI<\/td>\nC<\/td>\nTi\u1ebfp t\u1ee5c beta-blocker n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc trong thai k\u1ef3 \u1edf ph\u1ee5 n\u1eef CMP, theo d\u00f5i s\u00e1t s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a thai.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Thay \u0111\u1ed5i khuy\u1ebfn c\u00e1o (2)<\/h2>\n\n\n\n\n\n\n
2018 Guidelines<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n2025 Guidelines<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
Section 8. Khuy\u1ebfn c\u00e1o v\u1ec1 b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 ph\u1eabu thu\u1eadt tim \u1edf ph\u1ee5 n\u1eef c\u00f3 thai<\/strong><\/td>\n<\/tr>\n
Mang thai kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u1edf b\u1ec7nh nh\u00e2n h\u1ed9i ch\u1ee9ng Ehlers\u2013Danlos m\u1ea1ch m\u00e1u<\/td>\nIII<\/td>\nC<\/td>\nKhuy\u1ebfn c\u00e1o ph\u1ee5 n\u1eef m\u1eafc h\u1ed9i ch\u1ee9ng Ehlers\u2013Danlos m\u1ea1ch m\u00e1u mu\u1ed1n mang thai ph\u1ea3i \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n v\u1ec1 nguy c\u01a1 r\u1ea5t cao c\u1ee7a bi\u1ebfn c\u1ed1 thai k\u1ef3, b\u1edfi nh\u00f3m \u0111a chuy\u00ean khoa, c\u00e2n nh\u1eafc ti\u1ec1n s\u1eed gia \u0111\u00ecnh, bi\u1ebfn th\u1ec3 gen v\u00e0 c\u00e1c bi\u1ebfn c\u1ed1 m\u1ea1ch m\u00e1u tr\u01b0\u1edbc \u0111\u00f3.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Li\u1ec7u ph\u00e1p beta-blocker su\u1ed1t thai k\u1ef3 n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef m\u1eafc h\u1ed9i ch\u1ee9ng Marfan v\u00e0 c\u00e1c b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 ng\u1ef1c di truy\u1ec1n kh\u00e1c<\/td>\nIIa<\/td>\nC<\/td>\nLi\u1ec7u ph\u00e1p beta-blocker trong su\u1ed1t thai k\u1ef3 v\u00e0 c\u1ea3 h\u1eadu s\u1ea3n \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u1edf ph\u1ee5 n\u1eef MFS v\u00e0 c\u00e1c b\u1ec7nh HTAD kh\u00e1c.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Thay \u0111\u1ed5i khuy\u1ebfn c\u00e1o (3)<\/h2>\n\n\n\n\n\n\n\n
2018 Guidelines<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n2025 Guidelines<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
Section 9. Khuy\u1ebfn c\u00e1o v\u1ec1 b\u1ec7nh tim b\u1ea9m sinh v\u00e0 thai k\u1ef3<\/strong><\/td>\n<\/tr>\n
B\u1ec7nh nh\u00e2n c\u00f3 th\u1ea5t ph\u1ea3i h\u1ec7 th\u1ed1ng (Mustard\/Senning ho\u1eb7c TGA \u0111\u01b0\u1ee3c s\u1eeda ch\u1eefa b\u1ea9m sinh), NYHA III\/IV, r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1ea5t h\u1ec7 th\u1ed1ng (EF <40%), ho\u1eb7c TR n\u1eb7ng n\u00ean \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o tr\u00e1nh mang thai.<\/td>\nIIa<\/td>\nC<\/td>\nKhuy\u1ebfn c\u00e1o ph\u1ee5 n\u1eef c\u00f3 th\u1ea5t ph\u1ea3i h\u1ec7 th\u1ed1ng (Mustard\/Senning ho\u1eb7c TGA \u0111\u01b0\u1ee3c s\u1eeda ch\u1eefa b\u1ea9m sinh), NYHA III\/IV, r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1ea5t h\u1ec7 th\u1ed1ng (EF <40%), ho\u1eb7c TR n\u1eb7ng ph\u1ea3i \u0111\u01b0\u1ee3c Pregnancy Heart Team t\u01b0 v\u1ea5n v\u1ec1 nguy c\u01a1 cao c\u1ee7a bi\u1ebfn c\u1ed1 thai k\u1ef3<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Section 12. Khuy\u1ebfn c\u00e1o cho b\u1ec7nh tim m\u1eafc ph\u1ea3i v\u00e0 thai k\u1ef3<\/strong><\/td>\n<\/tr>\n
Chi\u1ebfn l\u01b0\u1ee3c can thi\u1ec7p n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf NSTE ACS c\u00f3 ti\u00eau ch\u00ed nguy c\u01a1 cao<\/td>\nIIa<\/td>\nC<\/td>\nKhuy\u1ebfn c\u00e1o qu\u1ea3n l\u00fd ph\u1ee5 n\u1eef mang thai m\u1eafc ACS t\u01b0\u01a1ng t\u1ef1 nh\u01b0 ph\u1ee5 n\u1eef kh\u00f4ng mang thai, bao g\u1ed3m ch\u1ea9n \u0111o\u00e1n v\u00e0 can thi\u1ec7p<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Thay \u0111\u1ed5i khuy\u1ebfn c\u00e1o (4)<\/h2>\n\n\n\n\n\n\n\n
2018 Guidelines<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n2025 Guidelines<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
Section 12. Khuy\u1ebfn c\u00e1o cho b\u1ec7nh tim m\u1eafc ph\u1ea3i v\u00e0 thai k\u1ef3 (ti\u1ebfp)<\/strong><\/td>\n<\/tr>\n
Tri\u1ec7t \u0111\u1ed1t b\u1eb1ng h\u1ec7 th\u1ed1ng \u0111i\u1ec7n gi\u1ea3i ph\u1eabu n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc t\u1ea1i c\u00e1c trung t\u00e2m c\u00f3 kinh nghi\u1ec7m trong tr\u01b0\u1eddng h\u1ee3p SVT kh\u00e1ng thu\u1ed1c v\u00e0 dung n\u1ea1p k\u00e9m<\/td>\nIIa<\/td>\nC<\/td>\nTri\u1ec7t \u0111\u1ed1t c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef mang thai c\u00f3 SVT t\u00e1i ph\u00e1t, tri\u1ec7u ch\u1ee9ng k\u00e9o d\u00e0i ho\u1eb7c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1edbi \u0111i\u1ec1u tr\u1ecb thu\u1ed1c.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n
Nong van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1eb1ng b\u00f3ng n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc trong thai k\u1ef3 \u1edf b\u1ec7nh nh\u00e2n h\u1eb9p van \u0110MC n\u1eb7ng v\u00e0 tri\u1ec7u ch\u1ee9ng n\u1eb7ng<\/td>\nIIa<\/td>\nC<\/td>\n\u1ede nh\u1eefng ph\u1ee5 n\u1eef mang thai c\u00f3 tri\u1ec7u ch\u1ee9ng h\u1eb9p van \u0110MC n\u1eb7ng kh\u00f4ng \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb n\u1ed9i, c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc l\u1ef1a ch\u1ecdn kh\u00f4ng ph\u1eabu thu\u1eadt nh\u01b0 nong van b\u1eb1ng b\u00f3ng ho\u1eb7c TAVI.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n
Van sinh h\u1ecdc n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef tr\u1ebb c\u00f3 \u00fd \u0111\u1ecbnh mang thai.<\/td>\nIIa<\/td>\nC<\/td>\nVan sinh h\u1ecdc \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o (\u01b0u ti\u00ean h\u01a1n van c\u01a1 h\u1ecdc) \u1edf ph\u1ee5 n\u1eef tr\u1ebb c\u00f3 \u00fd \u0111\u1ecbnh mang thai v\u00e0 c\u1ea7n thay van<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Thay \u0111\u1ed5i khuy\u1ebfn c\u00e1o (5)<\/h2>\n\n\n\n\n\n
2018 Guidelines<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n2025 Guidelines<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
Section 12. Khuy\u1ebfn c\u00e1o cho b\u1ec7nh tim m\u1eafc ph\u1ea3i v\u00e0 thai k\u1ef3 (ti\u1ebfp)<\/strong><\/td>\n<\/tr>\n
Trong tam c\u00e1 nguy\u1ec7t 2 v\u00e0 3, LMWH k\u00e8m theo theo d\u00f5i n\u1ed3ng \u0111\u1ed9 anti-Xa v\u00e0 ch\u1ec9nh li\u1ec1u c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef c\u1ea7n li\u1ec1u cao VKA sau khi \u0111\u00e3 \u0111\u01b0\u1ee3c gi\u1ea3i th\u00edch v\u00e0 \u0111\u1ed3ng thu\u1eadn.<\/td>\nIIb<\/td>\nC<\/td>\nTrong tam c\u00e1 nguy\u1ec7t 2 v\u00e0 3 cho \u0111\u1ebfn tu\u1ea7n 36, n\u00ean c\u00e2n nh\u1eafc ti\u1ebfp t\u1ee5c VKA \u1edf ph\u1ee5 n\u1eef c\u00f3 van tim nh\u00e2n t\u1ea1o nguy c\u01a1 cao huy\u1ebft kh\u1ed1i.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
<\/div>\n
\"H\u00ecnh
H\u00ecnh 2. Sinh l\u00fd h\u1ecdc c\u1ee7a c\u00e1c thay \u0111\u1ed5i huy\u1ebft \u0111\u1ed9ng v\u00e0 c\u00e1c thay \u0111\u1ed5i tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 v\u00e0 si\u00eau \u00e2m tim trong v\u00e0 sau thai k\u1ef3<\/figcaption><\/figure>\n
\"H\u00ecnh
H\u00ecnh 3. Nh\u00f3m Tim m\u1ea1ch Thai k\u1ef3 \u2013 \u0110\u1ed9i ng\u0169 \u0111a chuy\u00ean khoa<\/figcaption><\/figure>\n

Modified WHO 2.0 ph\u00e2n t\u1ea7ng nguy c\u01a1 tim m\u1ea1ch<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
mWHO 2.0 I<\/strong><\/td>\nmWHO 2.0 II<\/strong><\/td>\nmWHO 2.0 II\u2013III<\/strong><\/td>\nmWHO 2.0 III<\/strong><\/td>\nmWHO 2.0 IV<\/strong><\/td>\n<\/tr>\n
Suy ch\u1ee9c n\u0103ng th\u1ea5t + t\u0103ng \u00e1p ph\u1ed5i<\/strong><\/td>\n<\/tr>\n
<\/td>\n<\/td>\n– Suy LV nh\u1eb9: EF >45%<\/p>\n

– Suy n\u1eb7ng RV (d\u01b0\u1edbi ph\u1ed5i)<\/td>\n

– Suy LV v\u1eeba: EF 30\u201345%<\/p>\n

– PPCM tr\u01b0\u1edbc \u0111\u00f3, ch\u1ec9 c\u00f2n suy LV nh\u1eb9 t\u1ed3n d\u01b0<\/td>\n

– Suy LV n\u1eb7ng: EF < 30% ho\u1eb7c NYHA III\/IV<\/p>\n

– PPCM tr\u01b0\u1edbc \u0111\u00f3, t\u1ed3n d\u01b0 suy LV t\u1eeb m\u1ee9c \u0111\u1ed9 v\u1eeba<\/p>\n

– T\u0103ng \u00e1p ph\u1ed5i<\/td>\n<\/tr>\n

R\u1ed1i lo\u1ea1n nh\u1ecbp<\/strong><\/td>\n<\/tr>\n
Ngo\u1ea1i t\u00e2m thu nh\u0129\/th\u1ea5t \u0111\u01a1n \u0111\u1ed9c)<\/td>\n– \u0110a s\u1ed1 lo\u1ea1n nh\u1ecbp tr\u00ean th\u1ea5t<\/p>\n

– Nh\u1ecbp ch\u1eadm c\u1ea7n m\u00e1y t\u1ea1o nh\u1ecbp<\/td>\n

– LQTS nguy c\u01a1 th\u1ea5p: kh\u00f4ng c\u00f3 bi\u1ebfn c\u1ed1 tr\u01b0\u1edbc \u0111\u00f3 + \u0111i\u1ec1u tr\u1ecb beta- blocker li\u1ec1u \u0111\u1ea7y \u0111\u1ee7<\/p>\n

– CPVT nguy c\u01a1 th\u1ea5p: ki\u1ec3m so\u00e1t t\u1ed1t b\u1eb1ng thu\u1ed1c<\/p>\n

– Brugada ch\u01b0a c\u00f3 bi\u1ebfn c\u1ed1<\/td>\n

– Nh\u1ecbp nhanh th\u1ea5t duy tr\u00ec do m\u1ecdi nguy\u00ean nh\u00e2n LQT2 (post partum)<\/p>\n

– CPVT v\u00e0 LQTS c\u00f3 tri\u1ec7u ch\u1ee9ng, kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u1ee7 b\u1eb1ng thu\u1ed1c<\/p>\n

– Brugada c\u00f3 bi\u1ebfn c\u1ed1 tr\u01b0\u1edbc \u0111\u00f3<\/td>\n

<\/td>\n<\/tr>\n
B\u1ec7nh l\u00fd c\u01a1 tim<\/strong><\/td>\n<\/tr>\n
HCM: d\u01b0\u01a1ng t\u00ednh gen nh\u01b0ng ch\u01b0a bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng<\/td>\n<\/td>\n– ARVC nguy c\u01a1 th\u1ea5p: d\u01b0\u01a1ng t\u00ednh gen + kh\u00f4ng\/\u00edt bi\u1ec3u hi\u1ec7n<\/p>\n

– HCM kh\u00f4ng bi\u1ebfn ch\u1ee9ng<\/p>\n

– DCM\/NDLVC v\u1edbi EF >45%<\/td>\n

– ARVC m\u1ee9c \u0111\u1ed9 v\u1eeba\/n\u1eb7ng<\/p>\n

– HCM c\u00f3 bi\u1ebfn ch\u1ee9ng lo\u1ea1n nh\u1ecbp\/huy\u1ebft \u0111\u1ed9ng<\/p>\n

– DCM\/NDLVC v\u1edbi EF 30\u201345%<\/td>\n

– DCM\/NDLVC v\u1edbi EF < 30% ho\u1eb7c NYHA III\/IV<\/p>\n

– HCM t\u1eafc ngh\u1ebdn LVOT n\u1eb7ng \u2265 50 mmHg<\/p>\n

– HCM v\u1edbi suy LV n\u1eb7ng (EF < 50%)<\/td>\n<\/tr>\n

B\u1ec7nh l\u00fd van tim<\/strong><\/td>\n<\/tr>\n
– H\u1eb9p \u0110MP nh\u1eb9\/nh\u1ecf<\/p>\n

– Sa van 2 l\u00e1 kh\u00f4ng h\u1edf \u0111\u00e1ng k\u1ec3<\/td>\n

<\/td>\nB\u1ec7nh van g\u1ed1c, \u0111\u1ed3ng lo\u1ea1i ho\u1eb7c m\u00f4 h\u1ecdc kh\u00f4ng thu\u1ed9c nh\u00f3m I\/IV: h\u1eb9p 2 l\u00e1 nh\u1eb9, h\u1eb9p \u0110MC v\u1eeba, h\u1eb9p \u0110MP v\u1eeba, h\u1edf van v\u1eeba<\/td>\n– Van c\u01a1 h\u1ecdc kh\u00f4ng bi\u1ebfn ch\u1ee9ng, INR \u1ed5n \u0111\u1ecbnh. H\u1eb9p 2 l\u00e1 m\u1ee9c \u0111\u1ed9 v\u1eeba<\/p>\n

– H\u1eb9p \u0110MC n\u1eb7ng ko tri\u1ec7u ch\u1ee9ng<\/p>\n

– H\u1edf van tim tr\u00e1i n\u1eb7ng<\/td>\n

– H\u1eb9p \u0110MC n\u1eb7ng c\u00f3 tri\u1ec7u ch\u1ee9ng<\/p>\n

– H\u1eb9p 2 l\u00e1 n\u1eb7ng<\/td>\n<\/tr>\n

B\u1ec7nh tim b\u1ea9m sinh<\/strong><\/td>\n<\/tr>\n
T\u1ed5n th\u01b0\u01a1ng \u0111\u01a1n gi\u1ea3n \u0111\u00e3 s\u1eeda th\u00e0nh c\u00f4ng, kh\u00f4ng c\u00f2n bi\u1ebfn ch\u1ee9ng t\u1ed3n d\u01b0 \u0111\u00e1ng k\u1ec3: ASD, VSD, PDA, APVD.<\/td>\n– ASD\/VSD \u0111\u01a1n gi\u1ea3n ch\u01b0a m\u1ed5
\n– TOF \u0111\u00e3 m\u1ed5, kh\u00f4ng bi\u1ebfn ch\u1ee9ng \u0111\u00e1ng k\u1ec3
\n– TGA \u0111\u00e3 chuy\u1ec3n v\u1ecb \u0111\u1ed9ng m\u1ea1ch, kh\u00f4ng bi\u1ebfn ch\u1ee9ng \u0111\u00e1ng k\u1ec3<\/td>\n		– AVSD \u0111\u00e3 s\u1eeda, kh\u00f4ng bi\u1ebfn ch\u1ee9ng \u0111\u00e1ng k\u1ec3
\n– D\u1ecb t\u1eadt Ebstein \u0111\u01a1n gi\u1ea3n: h\u1edf ba l\u00e1 nh\u1eb9-v\u1eeba, kh\u00f4ng h\u1eb9p 3 l\u00e1, kh\u00f4ng \u0111\u01b0\u1eddng ph\u1ee5<\/td>\n		– CHD t\u00edm ch\u01b0a m\u1ed5, kh\u00f4ng ph\u1ea3i Eisenmenger<\/p>\n

– Suy nh\u1eb9 RV<\/p>\n

– Tu\u1ea7n ho\u00e0n Fontan kh\u00f4ng bi\u1ebfn ch\u1ee9ng<\/p>\n

– D\u1ecb t\u1eadt Ebstein nh\u1eb9, kh\u00f4ng bi\u1ebfn ch\u1ee9ng<\/td>\n

– RV h\u1ec7 th\u1ed1ng suy v\u1eeba\/n\u1eb7ng<\/p>\n

– Tu\u1ea7n ho\u00e0n Fontan c\u00f3 bi\u1ebfn ch\u1ee9ng<\/p>\n

– H\u1ed9i ch\u1ee9ng Eisenmenger<\/p>\n

 <\/td>\n<\/tr>\n

B\u1ec7nh van \u0110MC<\/strong><\/td>\n<\/tr>\n
Gi\u00e3n \u0110MC nh\u1eb9, kh\u00f4ng HTAD, <40 mm<\/td>\nTurner kh\u00f4ng k\u00e8m b\u1ea5t th\u01b0\u1eddng tim m\u1ea1ch<\/td>\n– Marfan ho\u1eb7c HTAD kh\u00e1c, kh\u00f4ng gi\u00e3n \u0110MC<\/p>\n

– \u0110MC <45 mm trong BAV<\/p>\n

– \u0110\u00e3 s\u1eeda h\u1eb9p eo \u0110MC<\/td>\n

– Gi\u00e3n v\u1eeba: Marfan\/HTAD 40\u201345mm; BAV\/Turner 45\u201350 mm; ASI > 20\u201325 mm\/m\u00b2; gi\u00e3n kh\u00e1c < 50 mm<\/p>\n

– Marfan \u0111\u00e3 thay g\u1ed1c \u0110MC<\/p>\n

– B\u00f3c t\u00e1ch \u0110MC c\u0169, \u0111\u01b0\u1eddng k\u00ednh \u1ed5n \u0111\u1ecbnh<\/td>\n

– Gi\u00e3n n\u1eb7ng: >45 mm Marfan\/HTAD; >50 mm BAV\/Turner; ASI >25 mm\/m\u00b2; gi\u00e3n kh\u00e1c >50 mm; Ehlers\u2013 Danlos m\u1ea1ch; h\u1eb9p eo \u0110MC n\u1eb7ng; b\u00f3c t\u00e1ch ti\u1ebfn tri\u1ec3n<\/p>\n

– H\u1ed9i ch\u1ee9ng m\u1ea1ch Ehlers\u2013 Danlos<\/p>\n

– H\u1eb9p eo \u0110MC n\u1eb7ng<\/p>\n

– B\u00f3c t\u00e1ch \u0110MC c\u0169, \u0111\u01b0\u1eddng k\u00ednh
\nt\u0103ng<\/td>\n<\/tr>\n

B\u1ec7nh tim m\u1eafc ph\u1ea3i + m\u1ea1ch v\u00e0nh + kh\u00e1c<\/strong><\/td>\n<\/tr>\n
<\/td>\n<\/td>\n<\/td>\nSCAD tr\u01b0\u1edbc \u0111\u00f3; bi\u1ebfn c\u1ed1 thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 tr\u01b0\u1edbc; APO c\u1ea7n nh\u1eadp vi\u1ec7n; t\u00e1c d\u1ee5ng ph\u1ee5 tim m\u1ea1ch c\u1ee7a \u0111i\u1ec1u tr\u1ecb ung th\u01b0.<\/td>\n<\/td>\n<\/tr>\n
Nguy c\u01a1<\/strong><\/td>\n<\/tr>\n
(Kh\u00f4ng t\u0103ng nguy c\u01a1 t\u1eed vong m\u1eb9, kh\u00f4ng\/t\u0103ng nh\u1eb9 bi\u1ebfn ch\u1ee9ng<\/td>\nT\u0103ng nh\u1eb9 nguy c\u01a1 t\u1eed vong\/bi\u1ebfn ch\u1ee9ng<\/td>\nT\u0103ng trung b\u00ecnh nguy c\u01a1 t\u1eed vong\/bi\u1ebfn ch\u1ee9ng<\/td>\nT\u0103ng r\u00f5 r\u1ec7t nguy c\u01a1 t\u1eed vong\/bi\u1ebfn ch\u1ee9ng<\/td>\nNguy c\u01a1 c\u1ef1c cao t\u1eed vong\/bi\u1ebfn ch\u1ee9ng<\/td>\n<\/tr>\n
T\u1ec9 l\u1ec7 t\u1eed vong tim m\u1ea1ch trung b\u00ecnh \u1edf s\u1ea3n ph\u1ee5<\/strong><\/td>\n<\/tr>\n
Van Hagen et al 2016<\/em><\/td>\n<\/tr>\n
9.9%<\/td>\n7.7%<\/td>\n17.7%<\/td>\n28.9%<\/td>\n50.3%<\/td>\n<\/tr>\n
Silversides et al 2018<\/em><\/td>\n<\/tr>\n
3.1%<\/td>\n21.7%<\/td>\n12.8%<\/td>\n21.1%<\/td>\n35.6%<\/td>\n<\/tr>\n
C\u00e1 th\u1ec3 ho\u00e1 nguy c\u01a1 \u1edf s\u1ea3n ph\u1ee5 theo h\u01b0\u1edbng d\u1eabn b\u00ean d\u01b0\u1edbi (d\u1eabn ch\u1ee9ng t\u1eeb CARPREG II)<\/strong><\/td>\n<\/tr>\n
CARPREG II score:1 point<\/p>\n

– Kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh can thi\u1ec7p tim m\u1ea1ch<\/p>\n

– \u0110\u00e1nh gi\u00e1 \u1edf giai \u0111o\u1ea1n mu\u1ed9n c\u1ee7a thai k\u1ef3<\/td>\n

CARPREG II score :2 \u0111i\u1ec3m<\/p>\n

– R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1ea5t<\/p>\n

– B\u1ec7nh van tim tr\u00e1i nguy c\u01a1 cao ho\u1eb7c t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng ra<\/p>\n

– T\u0103ng \u00e1p ph\u1ed5i<\/p>\n

– B\u1ec7nh m\u1ea1ch v\u00e0nh<\/p>\n

– B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 nguy c\u01a1 cao<\/td>\n

CARPREG II score:3 \u0111i\u1ec3m<\/p>\n

– Bi\u1ebfn c\u1ed1 tim ho\u1eb7c lo\u1ea1n nh\u1ecbp tr\u01b0\u1edbc \u0111\u00f3<\/p>\n

– NYHA III\/IV n\u1ec1n ho\u1eb7c t\u00edm<\/p>\n

– Van c\u01a1 h\u1ecdc<\/td>\n<\/tr>\n

S\u1ef1 ph\u1ed5i h\u1ee3p c\u1ee7a Pregnancy Heart Team<\/strong><\/td>\n<\/tr>\n
Kh\u00f4ng<\/td>\nKh\u00f4ng<\/td>\nC\u00f3<\/td>\nC\u00f3<\/td>\nC\u00f3<\/td>\n<\/tr>\n
T\u01b0 v\u1ea5n<\/strong><\/td>\n<\/tr>\n
C\u00f3 (b\u1edfi nh\u00e2n vi\u00ean y t\u1ebf
\nth\u01b0\u1eddng quy)<\/td>\n		C\u00f3 (b\u1edfi nh\u00e2n vi\u00ean y t\u1ebf th\u01b0\u1eddng
\nquy)<\/td>\n		Yes: expert counselling by Pregnancy Heart Team is required<\/td>\nC\u00f3: b\u1eaft bu\u1ed9c t\u01b0 v\u1ea5n chuy\u00ean s\u00e2u b\u1edfi Pregnancy Heart Team<\/td>\nC\u00f3: c\u1ea7n c\u00f3 s\u1ef1 t\u01b0 v\u1ea5n chuy\u00ean m\u00f4n c\u1ee7a Pregnancy Heart Team, v\u1edbi th\u1ea3o lu\u1eadn r\u00f5 r\u00e0ng v\u00e0 k\u1ef9 l\u01b0\u1ee1ng v\u1ec1 nguy c\u01a1 mang thai r\u1ea5t cao v\u00e0 qu\u00e1 tr\u00ecnh ra quy\u1ebft \u0111\u1ecbnh chung v\u1ec1 vi\u1ec7c ch\u1ea5m d\u1ee9t thai k\u1ef3 n\u1ebfu x\u1ea3y ra thai k\u1ef3.<\/td>\n<\/tr>\n
Ch\u0103m s\u00f3c s\u1ea3n khoa v\u00e0 tim m\u1ea1ch trong thai k\u1ef3<\/td>\n<\/tr>\n
B\u1ec7nh vi\u1ec7n \u0111\u1ecba ph\u01b0\u01a1ng<\/td>\nB\u1ec7nh vi\u1ec7n \u0111\u1ecba ph\u01b0\u01a1ng<\/td>\nChia s\u1ebb ch\u0103m s\u00f3c v\u1edbi b\u1ec7nh vi\u1ec7n \u0111\u1ecba ph\u01b0\u01a1ng + Pregnancy Heart Team<\/td>\nCh\u0103m s\u00f3c do Pregnancy Heart Team ch\u1ec9 \u0111\u1ea1o t\u1ea1i trung t\u00e2m chuy\u00ean khoa<\/td>\n\u00a0Ch\u0103m s\u00f3c do Pregnancy Heart Team ch\u1ec9 \u0111\u1ea1o t\u1ea1i trung t\u00e2m chuy\u00ean khoa<\/td>\n<\/tr>\n
N\u01a1i \u0111\u1ebb<\/strong><\/td>\n<\/tr>\n
B\u1ec7nh vi\u1ec7n \u0111\u1ecba ph\u01b0\u01a1ng<\/td>\nB\u1ec7nh vi\u1ec7n \u0111\u1ecba ph\u01b0\u01a1ng<\/td>\nChia s\u1ebb ch\u0103m s\u00f3c v\u1edbi b\u1ec7nh vi\u1ec7n \u0111\u1ecba ph\u01b0\u01a1ng + Pregnancy Heart Team. \u0110\u1ecba \u0111i\u1ec3m sinh ph\u1ee5 thu\u1ed9c v\u00e0o t\u00ecnh tr\u1ea1ng tim m\u1ea1ch v\u00e0 ti\u1ebfn tri\u1ec3n c\u1ee7a thai k\u1ef3<\/td>\nB\u1ec7nh vi\u1ec7n chuy\u00ean khoa, d\u01b0\u1edbi s\u1ef1 ch\u1ec9 \u0111\u1ea1o c\u1ee7a Pregnancy Heart Team<\/td>\nB\u1ec7nh vi\u1ec7n chuy\u00ean khoa, d\u01b0\u1edbi s\u1ef1 ch\u1ec9 \u0111\u1ea1o c\u1ee7a Pregnancy Heart Team<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\"T\u1ef7
T\u1ef7 l\u1ec7 xu\u1ea5t hi\u1ec7n bi\u1ebfn ch\u1ee9ng tim m\u1ea1ch \u1edf s\u1ea3n ph\u1ee5<\/figcaption><\/figure>\n
\"H\u00ecnh
H\u00ecnh 4. T\u01b0 v\u1ea5n tr\u01b0\u1edbc khi mang thai v\u00e0 c\u00e1c kh\u00eda c\u1ea1nh di truy\u1ec1n<\/figcaption><\/figure>\n

L\u1ef1a ch\u1ecdn v\u00e0 \u00fd ngh\u0129a trong giai \u0111o\u1ea1n ti\u1ec1n l\u00e0m t\u1ed5 v\u00e0 ch\u1ea9n \u0111o\u00e1n tr\u01b0\u1edbc sinh<\/h2>\n\n\n\n\n\n\n\n\n
Ch\u1ea9n \u0111o\u00e1n di truy\u1ec1n ti\u1ec1n l\u00e0m
\nt\u1ed5<\/td>\n		Th\u1ee5 tinh trong \u1ed1ng nghi\u1ec7m (IVF) k\u00e8m sinh thi\u1ebft v\u00e0 x\u00e9t nghi\u1ec7m di truy\u1ec1n m\u1ed9t t\u1ebf b\u00e0o c\u1ee7a ph\u00f4i. T\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng khi chuy\u1ec3n ph\u00f4i: 25\u201330% (ph\u1ee5 thu\u1ed9c tu\u1ed5i m\u1eb9 v\u00e0 kh\u1ea3 n\u0103ng sinh s\u1ea3n)<\/td>\n<\/tr>\n
R\u1ee7i ro cho m\u1eb9 v\u00e0 thai nh\u01b0: \u0111a thai, sinh non, c\u00e2n n\u1eb7ng th\u1ea5p, t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a \u0111i\u1ec1u tr\u1ecb hormon. T\u00ednh kh\u1ea3 d\u1ee5ng, chi ph\u00ed v\u00e0 ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c nhau t\u00f9y qu\u1ed1c gia.<\/td>\n<\/tr>\n
Sinh thi\u1ebft gai nhau<\/td>\nCh\u1ecdc qua c\u1ed5 t\u1eed cung ho\u1eb7c th\u00e0nh b\u1ee5ng \u0111\u1ec3 l\u1ea5y gai nhau cu\u1ed1i tam c\u00e1 nguy\u1ec7t I.<\/td>\n<\/tr>\n
T\u1ef7 l\u1ec7 s\u1ea9y thai li\u00ean quan th\u1ee7 thu\u1eadt kho\u1ea3ng 0,2%.<\/td>\n<\/tr>\n
Ch\u1ecdc \u1ed1i<\/td>\nL\u1ea5y tr\u1ef1c ti\u1ebfp d\u1ecbch \u1ed1i sau 15 tu\u1ea7n thai<\/td>\n<\/tr>\n
T\u1ef7 l\u1ec7 s\u1ea9y thai li\u00ean quan th\u1ee7 thu\u1eadt kho\u1ea3ng 0,1%.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

T\u1ed5ng quan l\u1ee3i \u00edch v\u00e0 nguy c\u01a1 c\u1ee7a c\u00e1c ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai \u1edf ph\u1ee5 n\u1eef b\u1ec7nh tim m\u1ea1ch (CVD)<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Ph\u01b0\u01a1ng ph\u00e1p<\/strong><\/td>\nL\u1ee3i \u00edch<\/strong><\/td>\nNguy c\u01a1 tim m\u1ea1ch<\/strong><\/td>\nTh\u1eadn tr\u1ecdng \/ ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh<\/strong><\/td>\nHi\u1ec7u qu\u1ea3 tr\u00e1nh thai<\/strong><\/td>\n<\/tr>\n
Hormone \u0111\u01b0\u1eddng u\u1ed1ng<\/strong><\/td>\n<\/tr>\n
Ch\u1ec9 ch\u1ee9a progestin<\/td>\n\u00cdt\/kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u.<\/td>\nH\u1ed3 s\u01a1 nguy c\u01a1 tim m\u1ea1ch an to\u00e0n.<\/td>\nGi\u1eef n\u01b0\u1edbc nh\u1eb9. H\u1ed9i ch\u1ee9ng QT d\u00e0i n\u1ebfu kh\u00f4ng d\u00f9ng beta-blocker.<\/td>\n++ (th\u00f4ng th\u01b0\u1eddng)
\n+++ (drospirenone)<\/td>\n<\/tr>\n
K\u1ebft h\u1ee3p estrogen + progestin<\/p>\n

 <\/td>\n

Kinh nguy\u1ec7t \u0111\u1ec1u, gi\u1ea3m l\u01b0\u1ee3ng m\u00e1u m\u1ea5t.<\/td>\nT\u0103ng nguy c\u01a1 VTE, t\u0103ng huy\u1ebft \u00e1p, r\u1ed1i lo\u1ea1n lipid m\u00e1u<\/td>\nR\u1ed1i lo\u1ea1n lipid m\u00e1u, t\u0103ng huy\u1ebft \u00e1p c\u00f3 s\u1eb5n, b\u00e9o ph\u00ec, t\u00edm, van tim c\u01a1 h\u1ecdc (MHV), tu\u1ea7n ho\u00e0n Fontan, y\u1ebfu t\u1ed1 nguy c\u01a1 b\u1ec7nh m\u1ea1ch v\u00e0nh c\u1ea5p (ACS).<\/td>\n+++<\/td>\n<\/tr>\n
Ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai h\u1ed3i t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i (LARC)<\/strong><\/td>\n<\/tr>\n
D\u1ee5ng c\u1ee5 t\u1eed cung levonorgestrel (LNG-IUD).<\/td>\n\u2193 Gi\u1ea3m kinh v\u00e0 m\u1ea5t s\u1eaft.<\/td>\nNone specified<\/td>\nPh\u1ea3n x\u1ea1 ph\u1ebf v\u1ecb khi \u0111\u1eb7t\/l\u1ea5y ra \u2192 c\u1ea7n th\u1ef1c hi\u1ec7n b\u1edfi b\u00e1c s\u0129 ph\u1ee5 khoa, theo d\u00f5i v\u00e0 c\u00f3 s\u1eb5n g\u00e2y m\u00ea h\u1ed3i s\u1ee9c. \u0110\u1eb7c bi\u1ec7t c\u00e2n nh\u1eafc \u1edf PAH v\u00e0 tu\u1ea7n ho\u00e0n Fontan.<\/td>\nHi\u1ec7u qu\u1ea3 nh\u1ea5t v\u00e0 an to\u00e0n nh\u1ea5t +++<\/td>\n<\/tr>\n
D\u1ee5ng c\u1ee5 t\u1eed cung LNG nh\u1ecf h\u01a1n<\/td>\n\u2193 Gi\u1ea3m kinh, m\u1ea5t s\u1eaft, D\u1ec5 \u0111\u1eb7t h\u01a1n.<\/p>\n

\u2193 Gi\u1ea3m nguy c\u01a1 ph\u1ea3n x\u1ea1 ph\u1ebf v\u1ecb<\/td>\n

Kh\u00f4ng ghi nh\u1eadn<\/td>\n<\/td>\n+++<\/td>\n<\/tr>\n
D\u1ee5ng c\u1ee5 t\u1eed cung \u0111\u1ed3ng<\/td>\n\u2193 Chi ph\u00ed th\u1ea5p<\/td>\nKh\u00f4ng ghi nh\u1eadn<\/td>\nC\u00f3 th\u1ec3 t\u0103ng l\u01b0\u1ee3ng m\u00e1u kinh.<\/td>\n+++<\/td>\n<\/tr>\n
C\u1ea5y d\u01b0\u1edbi da etonogestrel<\/td>\nKh\u00f4ng nguy c\u01a1 nhi\u1ec5m tr\u00f9ng v\u00f9ng ch\u1eadu.<\/td>\nKh\u00f4ng ghi nh\u1eadn<\/td>\nTh\u1ee7 thu\u1eadt \u0111\u1eb7t d\u01b0\u1edbi da c\u1eb3ng tay v\u1edbi g\u00e2y t\u00ea t\u1ea1i ch\u1ed7 (ngo\u1ea1i tr\u00fa).<\/td>\n+++<\/td>\n<\/tr>\n
Ti\u00eam depot medroxyprogester
\none acetate (DMPA)<\/td>\n		Gi\u1ea3m kinh.<\/td>\nT\u0103ng nguy c\u01a1 VTE, t\u0103ng c\u00e2n.<\/td>\nRong huy\u1ebft.<\/td>\n++<\/td>\n<\/tr>\n
H\u00e0ng r\u00e0o (bao cao su, m\u00e0ng ch\u1eafn)<\/strong><\/td>\n<\/tr>\n
<\/td>\nGi\u1ea3m nguy c\u01a1 nhi\u1ec5m tr\u00f9ng v\u00f9ng ch\u1eadu.<\/td>\n<\/td>\nKh\u00f4ng ghi nh\u1eadn.<\/td>\n+<\/td>\n<\/tr>\n
Tri\u1ec7t s\u1ea3n v\u0129nh vi\u1ec5n<\/strong><\/td>\n<\/tr>\n
Th\u1eaft \u1ed1ng d\u1eabn tr\u1ee9ng \/ Th\u1eaft \u1ed1ng d\u1eabn tinh<\/td>\nV\u0129nh vi\u1ec5n<\/td>\nNguy c\u01a1 g\u00e2y m\u00ea v\u00e0 th\u1ee7 thu\u1eadt.<\/td>\nKh\u00f4ng h\u1ed3i ph\u1ee5c.<\/td>\n+++<\/td>\n<\/tr>\n
Tr\u00e1nh thai kh\u1ea9n c\u1ea5p<\/strong><\/td>\n<\/tr>\n
Thu\u1ed1c u\u1ed1ng tr\u00ec ho\u00e3n r\u1ee5ng tr\u1ee9ng<\/strong><\/td>\n<\/tr>\n
Ulipristal acetate<\/td>\n\u2191 Effectiveness than levonorgestrel<\/td>\nNo \u2191 thrombosis risk<\/td>\nKh\u00f4ng ghi nh\u1eadn.<\/td>\n+++ (only if taken before ovulation)<\/td>\n<\/tr>\n
Levonorgestrel li\u1ec1u duy nh\u1ea5t 1,5mg < 72h sau giao h\u1ee3p kh\u00f4ng b\u1ea3o v\u1ec7<\/td>\n<\/td>\nNo \u2191 thrombosis risk<\/td>\nKh\u00f4ng ghi nh\u1eadn.<\/td>\n+++ (only if taken before ovulation)<\/td>\n<\/tr>\n
Contraceptive device<\/strong><\/td>\n<\/tr>\n
D\u1ee5ng c\u1ee5 t\u1eed cung \u0111\u1ed3ng (Cu-IUD) <120h sau giao h\u1ee3p kh\u00f4ng b\u1ea3o v\u1ec7<\/td>\n<\/td>\n<\/td>\nKh\u00f4ng ghi nh\u1eadn.<\/td>\n+++ (ngo\u00e0i hi\u1ec7u qu\u1ea3 th\u01b0\u1eddng quy)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Khuy\u1ebfn c\u00e1o v\u1ec1 t\u01b0 v\u1ea5n, \u0111\u00e1nh gi\u00e1 nguy c\u01a1 thai k\u1ef3, tr\u00e1nh thai, h\u1ed7 tr\u1ee3 sinh s\u1ea3n v\u00e0 s\u1ef1 tham gia c\u1ee7a Pregnancy Heart Team<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
\u0110\u00e1nh gi\u00e1 nguy c\u01a1 m\u1eb9<\/strong><\/td>\n<\/tr>\n
C\u1ea7n \u0111\u00e1nh gi\u00e1 nguy c\u01a1 \u1edf t\u1ea5t c\u1ea3 ph\u1ee5 n\u1eef m\u1eafc CVD trong \u0111\u1ed9 tu\u1ed5i sinh s\u1ea3n b\u1eb1ng ph\u00e2n lo\u1ea1i mWHO 2.0.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Th\u1ea3o lu\u1eadn c\u1ee7a Pregnancy Heart Team v\u1ec1 nguy c\u01a1 t\u1eed vong m\u1eb9 v\u00e0 nguy c\u01a1 thai cao li\u00ean quan \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o cho ph\u1ee5 n\u1eef thu\u1ed9c nh\u00f3m mWHO 2.0 class IV, bao g\u1ed3m qu\u00e1 tr\u00ecnh ra quy\u1ebft \u0111\u1ecbnh chung v\u1ec1 vi\u1ec7c ti\u1ebfp t\u1ee5c hay ch\u1ea5m d\u1ee9t thai k\u1ef3, k\u00e8m h\u1ed7 tr\u1ee3 t\u00e2m l\u00fd.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Ph\u1ee5 n\u1eef m\u1eafc CVD thu\u1ed9c mWHO 2.0 class II\u2013III tr\u1edf l\u00ean c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 v\u00e0 qu\u1ea3n l\u00fd b\u1edfi Pregnancy Heart Team t\u1eeb tr\u01b0\u1edbc khi mang thai \u0111\u1ebfn sau sinh.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai<\/strong><\/td>\n<\/tr>\n
Ph\u1ee5 n\u1eef m\u1eafc CVD class II tr\u1edf l\u00ean (mWHO 2.0) ho\u1eb7c c\u00f3 nguy c\u01a1 ph\u00e1t tri\u1ec3n CVD c\u1ea7n \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n c\u00e1 th\u1ec3 h\u00f3a \u0111\u1ec3 ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai th\u00edch h\u1ee3p, bao g\u1ed3m c\u1ea3 tr\u00e1nh thai kh\u1ea9n c\u1ea5p.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
\u0110i\u1ec1u tr\u1ecb ch\u1ec9 ch\u1ee9a progestin, c\u1ea5y d\u01b0\u1edbi da, ho\u1eb7c d\u1ee5ng c\u1ee5 t\u1eed cung levonorgestrel (LNG-IUD)
\nn\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc khi c\u00f3 nguy c\u01a1 thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i.<\/td>\n		IIa<\/td>\nB<\/td>\n<\/tr>\n
T\u01b0 v\u1ea5n di truy\u1ec1n<\/strong><\/td>\n<\/tr>\n
N\u00ean \u0111\u00e1nh gi\u00e1 b\u1edfi chuy\u00ean gia di truy\u1ec1n tr\u01b0\u1edbc khi mang thai \u0111\u1ed1i v\u1edbi ph\u1ee5 n\u1eef c\u00f3 ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n b\u1ec7nh tim m\u1ea1ch di truy\u1ec1n, nh\u1eb1m \u0111\u1ecbnh h\u01b0\u1edbng ph\u00e2n t\u1ea7ng nguy c\u01a1 v\u00e0 x\u00e9t nghi\u1ec7m di truy\u1ec1n ti\u1ec1n s\u1ea3n.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
T\u01b0 v\u1ea5n di truy\u1ec1n ti\u1ec1n th\u1ee5 thai \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u1edf c\u00e1c c\u1eb7p v\u1ee3 ch\u1ed3ng c\u00f3 CVD di truy\u1ec1n, b\u1ea5t k\u1ec3 c\u00f3 x\u00e9t nghi\u1ec7m di truy\u1ec1n hay kh\u00f4ng. C\u1ea7n th\u1ef1c hi\u1ec7n b\u1edfi chuy\u00ean gia y t\u1ebf trong nh\u00f3m \u0111a chuy\u00ean ng\u00e0nh, bao g\u1ed3m h\u1ed7 tr\u1ee3 t\u00e2m l\u00fd v\u00e0 gi\u00e1o d\u1ee5c.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
H\u1ed7 tr\u1ee3 sinh s\u1ea3n<\/strong><\/td>\n<\/tr>\n
N\u00ean th\u1ef1c hi\u1ec7n chuy\u1ec3n m\u1ed9t ph\u00f4i \u0111\u01a1n \u1edf ph\u1ee5 n\u1eef m\u1eafc CVD.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Ch\u1ea5m d\u1ee9t thai k\u00ec<\/strong><\/td>\n<\/tr>\n
Ph\u1ee5 n\u1eef m\u1eafc CVD c\u1ea7n \u0111\u01b0\u1ee3c cung c\u1ea5p l\u1ef1a ch\u1ecdn ch\u1ea5m d\u1ee9t thai k\u1ef3 ph\u00f9 h\u1ee3p v\u1edbi t\u00ecnh tr\u1ea1ng tim m\u1ea1ch \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 th\u1ee7 thu\u1eadt.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Khuy\u1ebfn c\u00e1o v\u1ec1 ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n trong thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
Si\u00eau \u00e2m tim<\/strong><\/td>\n<\/tr>\n
Si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c khuy\u1ebfn c\u00e1o l\u00e0 c\u00f4ng c\u1ee5 h\u00ecnh \u1ea3nh \u0111\u1ea7u tay \u1edf ph\u1ee5 n\u1eef mang thai c\u00f3 tri\u1ec7u ch\u1ee9ng ho\u1eb7c d\u1ea5u hi\u1ec7u tim m\u1ea1ch m\u1edbi\/xu\u1ea5t hi\u1ec7n l\u1ea7n \u0111\u1ea7u<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Biomarkers<\/strong><\/td>\n<\/tr>\n
BNP\/NT-proBNP c\u1ea7n \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u0111o tr\u01b0\u1edbc mang thai \u1edf ph\u1ee5 n\u1eef suy tim (m\u1ecdi c\u0103n nguy\u00ean, bao g\u1ed3m PPCM, b\u1ec7nh c\u01a1 tim, tim b\u1ea9m sinh, PAH), v\u00e0 theo d\u00f5i trong thai k\u1ef3 t\u00f9y b\u1ec7nh n\u1ec1n v\u00e0 tri\u1ec7u ch\u1ee9ng m\u1edbi\/x\u1ea5u \u0111i.<\/td>\nIIa<\/td>\nB<\/td>\n<\/tr>\n
C\u1ed9ng h\u01b0\u1edfng t\u1eeb tim<\/strong><\/td>\n<\/tr>\n
Ng\u01b0ng cho b\u00fa 24h khi c\u1ea7n ti\u00eam gadolinium t\u0129nh m\u1ea1ch.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
CMR kh\u00f4ng gadolinium n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh khi c\u1ea7n, n\u1ebfu ph\u01b0\u01a1ng ti\u1ec7n kh\u00f4ng x\u00e2m l\u1ea5n kh\u00e1c kh\u00f4ng \u0111\u1ee7.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
Ph\u00f3ng x\u1ea1 ion h\u00f3a<\/strong><\/td>\n<\/tr>\n
H\u1ea1n ch\u1ebf ph\u01a1i nhi\u1ec5m ph\u00f3ng x\u1ea1 ion h\u00f3a \u1edf m\u1ee9c ALARA.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
Li\u1ec1u x\u1ea1 t\u1edbi thai n\u00ean c\u00e0ng th\u1ea5p c\u00e0ng t\u1ed1t (<50 mGy), nh\u1ea5t l\u00e0 khi thai trong tr\u01b0\u1eddng chi\u1ebfu.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
CT scan n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc khi nghi PE v\u00e0 l\u1ee3i \u00edch v\u01b0\u1ee3t tr\u1ed9i nguy c\u01a1.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
X-quang ng\u1ef1c c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111\u1ea7u tay n\u1ebfu kh\u00f4ng c\u00f3 l\u1ef1a ch\u1ecdn kh\u00e1c \u0111\u1ec3 t\u00ecm nguy\u00ean nh\u00e2n kh\u00f3 th\u1edf.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n
Ch\u1ee5p m\u1ea1ch v\u00e0nh v\u1edbi li\u1ec1u x\u1ea1 t\u1ed1i thi\u1ec3u c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc khi l\u1ee3i \u00edch v\u01b0\u1ee3t nguy c\u01a1.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

C\u00e1c y\u1ebfu t\u1ed1 d\u1ef1 b\u00e1o bi\u1ebfn c\u1ed1 s\u01a1 sinh \u1edf thai k\u1ef3 c\u1ee7a ph\u1ee5 n\u1eef m\u1eafc CVD<\/h2>\n

Y\u1ebfu t\u1ed1 d\u1ef1 b\u00e1o<\/strong><\/p>\n

    \n
  • NYHA III\/IV ho\u1eb7c t\u00edm trong th\u0103m kh\u00e1m ti\u1ec1n s\u1ea3n ban \u0111\u1ea7u<\/li>\n
  • T\u1eafc ngh\u1ebdn th\u1ea5t tr\u00e1i \u1edf s\u1ea3n ph\u1ee5<\/li>\n
  • B\u00e3o h\u00f2a oxy m\u1eb9 <90%<\/li>\n
  • \u0110a thai<\/li>\n
  • S\u1eed d\u1ee5ng ch\u1ed1ng \u0111\u00f4ng<\/li>\n
  • D\u00f9ng thu\u1ed1c tim m\u1ea1ch tr\u01b0\u1edbc khi mang thai<\/li>\n
  • Van c\u01a1 h\u1ecdc<\/li>\n
  • Bi\u1ebfn c\u1ed1 tim m\u1ea1ch trong thai k\u1ef3<\/li>\n
  • Gi\u1ea3m cung l\u01b0\u1ee3ng tim m\u1eb9 trong thai k\u1ef3<\/li>\n<\/ul>\n
    \"H\u00ecnh
    H\u00ecnh 5. X\u1eed tr\u00ed sinh kh\u1ea9n c\u1ea5p \u1edf ph\u1ee5 n\u1eef \u0111ang d\u00f9ng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng<\/figcaption><\/figure>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 th\u1eddi \u0111i\u1ec3m v\u00e0 ph\u01b0\u01a1ng ph\u00e1p sinh<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    Th\u1eddi \u0111i\u1ec3m v\u00e0 ph\u01b0\u01a1ng ph\u00e1p sinh<\/strong><\/td>\n<\/tr>\n
    \u0110\u1ebb th\u01b0\u1eddng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u1edf \u0111a s\u1ed1 ph\u1ee5 n\u1eef m\u1eafc CVD.<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
    Kh\u00e1ng sinh d\u1ef1 ph\u00f2ng to\u00e0n th\u00e2n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef nguy c\u01a1 cao.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n
    Kh\u00f4ng khuy\u1ebfn c\u00e1o kh\u1edfi ph\u00e1t chuy\u1ec3n d\u1ea1 th\u01b0\u1eddng quy tr\u01b0\u1edbc 39 tu\u1ea7n \u1edf ph\u1ee5 n\u1eef CVD \u1ed5n \u0111\u1ecbnh.<\/td>\nIII<\/td>\nC<\/td>\n<\/tr>\n
    Ph\u1ee5 n\u1eef \u0111ang d\u00f9ng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng<\/strong><\/td>\n<\/tr>\n
    C\u1ea7n l\u1eadp k\u1ebf ho\u1ea1ch th\u1eddi \u0111i\u1ec3m sinh \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 ch\u1ed1ng \u0111\u00f4ng quanh sinh.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    N\u00ean ng\u1eebng VKA v\u00e0 b\u1eaft \u0111\u1ea7u LMWH li\u1ec1u \u0111i\u1ec1u tr\u1ecb ho\u1eb7c UFH \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch (li\u1ec1u ch\u1ec9nh) \u1edf tu\u1ea7n 36 ho\u1eb7c 2 tu\u1ea7n tr\u01b0\u1edbc sinh.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef nguy c\u01a1 th\u1ea5p \u0111ang d\u00f9ng LMWH li\u1ec1u \u0111i\u1ec1u tr\u1ecb, g\u00e2y t\u00ea th\u1ea7n kinh trung \u01b0\u01a1ng v\u00e0 \u0111\u1ebb th\u01b0\u1eddng (ho\u1eb7c m\u1ed5 l\u1ea5y thai v\u00ec ch\u1ec9 \u0111\u1ecbnh s\u1ea3n khoa) \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o sau 24h t\u1eeb li\u1ec1u cu\u1ed1i LMWH.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef nguy c\u01a1 cao, n\u00ean chuy\u1ec3n LMWH sang UFH \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch \u226536h tr\u01b0\u1edbc sinh v\u00e0 ng\u1eebng UFH 4\u20136h tr\u01b0\u1edbc sinh. C\u1ea7n \u0111\u1ea3m b\u1ea3o aPTT b\u00ecnh th\u01b0\u1eddng tr\u01b0\u1edbc g\u00e2y t\u00ea t\u1ea1i ch\u1ed7.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    N\u1ebfu chuy\u1ec3n d\u1ea1 x\u1ea3y ra khi b\u1ec7nh nh\u00e2n c\u00f2n d\u00f9ng VKA ho\u1eb7c <2 tu\u1ea7n sau khi ng\u1eebng VKA, n\u00ean m\u1ed5 l\u1ea5y thai \u0111\u1ec3 b\u1ea3o v\u1ec7 thai.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Sau sinh, quy\u1ebft \u0111\u1ecbnh kh\u1edfi l\u1ea1i LMWH\/UFH c\u1ea7n th\u1ea3o lu\u1eadn gi\u1eefa Pregnancy Heart Team v\u00e0 s\u1ea3n ph\u1ee5.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Chuy\u1ec3n \u0111\u1ed5i t\u1eeb heparin sang thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng \u0111\u01b0\u1eddng u\u1ed1ng n\u00ean tr\u00ec ho\u00e3n 7\u201314 ng\u00e0y sau sinh cho \u0111\u1ebfn khi li\u1ec1n v\u1ebft m\u1ed5, d\u01b0\u1edbi t\u01b0 v\u1ea5n c\u1ee7a Pregnancy Heart Team.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef \u0111ang d\u00f9ng LMWH li\u1ec1u \u0111i\u1ec1u tr\u1ecb, sinh n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc sau 39 tu\u1ea7n \u0111\u1ec3 tr\u00e1nh chuy\u1ec3n d\u1ea1 t\u1ef1 ph\u00e1t khi c\u00f2n ch\u1ed1ng \u0111\u00f4ng.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef d\u00f9ng ch\u1ed1ng \u0111\u00f4ng ti\u1ec1n s\u1ea3n, c\u1ea7n c\u00e2n nh\u1eafc x\u1eed tr\u00ed ch\u1ee7 \u0111\u1ed9ng giai \u0111o\u1ea1n 3 c\u1ee7a chuy\u1ec3n d\u1ea1 v\u1edbi oxytocin.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    C\u00e1c ph\u00e1c \u0111\u1ed3 ch\u1ed1ng \u0111\u00f4ng v\u00e0 b\u1ec7nh l\u00fd ch\u1ec9 \u0111\u1ecbnh<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
    Ch\u1ec9 \u0111\u1ecbnh<\/strong><\/td>\nLo\u1ea1i ch\u1ed1ng \u0111\u00f4ng<\/strong><\/td>\nLi\u1ec1u d\u00f9ng<\/strong><\/td>\nTh\u1eddi \u0111i\u1ec3m<\/strong><\/td>\n<\/tr>\n
    Nguy c\u01a1 huy\u1ebft kh\u1ed1i th\u1ea5p<\/strong><\/td>\n<\/tr>\n
    D\u1ef1 ph\u00f2ng VTE \/ kh\u00f4ng ch\u1ec9 \u0111\u1ecbnh ch\u1ed1ng \u0111\u00f4ng \u0111\u01b0\u1eddng u\u1ed1ng<\/td>\nLMWH<\/td>\nLi\u1ec1u d\u1ef1 ph\u00f2ng<\/td>\no.d.<\/td>\n<\/tr>\n
    Tu\u1ea7n ho\u00e0n Fontan ch\u01b0a bi\u1ebfn ch\u1ee9ng<\/td>\nLMWH<\/td>\nLi\u1ec1u d\u1ef1 ph\u00f2ng<\/td>\no.d.<\/td>\n<\/tr>\n
    Nguy c\u01a1 trung b\u00ecnh<\/strong><\/td>\n<\/tr>\n
    Huy\u1ebft kh\u1ed1i TM s\u00e2u khi \u0111ang mang thai<\/td>\nLMWH<\/td>\nLi\u1ec1u \u0111i\u1ec1u tr\u1ecb<\/td>\no.d. or b.i.d.<\/td>\n<\/tr>\n
    AF dai d\u1eb3ng \/ t\u00e1i ph\u00e1t v\u1edbi nguy c\u01a1 huy\u1ebft kh\u1ed1i cao<\/td>\nLMWH<\/td>\nLi\u1ec1u \u0111i\u1ec1u tr\u1ecb<\/td>\no.d. or b.i.d.<\/td>\n<\/tr>\n
    EF th\u1ea5t tr\u00e1i gi\u1ea3m (\u226435%) v\u00e0\/ho\u1eb7c huy\u1ebft kh\u1ed1i trong tim<\/td>\nLMWH<\/td>\nLi\u1ec1u \u0111i\u1ec1u tr\u1ecb<\/td>\no.d. or b.i.d.<\/td>\n<\/tr>\n
    Nguy c\u01a1 cao<\/strong><\/td>\n<\/tr>\n
    Van nh\u00e2n t\u1ea1o<\/td>\n<\/tr>\n
    1. Tam c\u00e1 nguy\u1ec7t I<\/strong><\/td>\n<\/tr>\n
    Li\u1ec1u VKA th\u1ea5p \u0111\u1ec3 \u0111\u1ea1t INR<\/td>\nTam c\u00e1 nguy\u1ec7t I: VKA ho\u1eb7c LMWH<\/td>\nINR: ki\u1ec3m tra 1-2 tu\u1ea7n\/l\u1ea7n<\/td>\n<\/tr>\n
    LMWH:\u0111i\u1ec1u ch\u1ec9nh li\u1ec1u d\u1ef1a tr\u00ean \u0111\u1ec9nh n\u1ed3ng \u0111\u1ed9 anti-Xa<\/td>\nb.i.d.<\/td>\n<\/tr>\n
    Li\u1ec1u VKA cao \u0111\u1ec3 \u0111\u1ea1t INR<\/td>\nChuy\u1ec3n sang LMWH<\/td>\nLMWH:\u0111i\u1ec1u ch\u1ec9nh li\u1ec1u d\u1ef1a tr\u00ean \u0111\u1ec9nh n\u1ed3ng \u0111\u1ed9 anti-Xa (x\u00e9t nghi\u1ec7m m\u1ed7i tu\u1ea7n t\u1edbi khi \u0111\u1ea1t y\/c -> m\u1ed7i 2-4 tu\u1ea7n)<\/td>\nb.i.d.<\/td>\n<\/tr>\n
    2. T\u1eeb tu\u1ea7n 13: Quy\u1ebft \u0111\u1ecbnh chung<\/strong><\/p>\n

    a. Ti\u1ebfp t\u1ee5c VKA, theo d\u00f5i INR m\u1ed7i 1\u20132 tu\u1ea7n.<\/p>\n

    b. Ho\u1eb7c LMWH ch\u1ec9nh li\u1ec1u nh\u01b0 tr\u00ean.<\/p>\n

    \u0110\u01b0\u1eddng \u0111\u1ebb:nh\u01b0 ph\u1ea7n Section 4.5.7.2 (cho \u0111\u1ebb kh\u1ea9n c\u1ea5p) v\u00e0 Section 4.5.7.1 (cho \u0111\u1ebb th\u01b0\u1eddng)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Li\u1ec1u d\u00f9ng LMWHs th\u01b0\u1eddng s\u1eed d\u1ee5ng<\/h2>\n\n\n\n\n\n\n
    <\/td>\nEnoxaparin<\/strong><\/td>\nDalteparin<\/strong><\/td>\nTinzaparin<\/strong><\/td>\nM\u1ee5c ti\u00eau<\/strong><\/td>\n<\/tr>\n
    D\u1ef1 ph\u00f2ng LMWH c\u00e2n n\u1eb7ng 50\u2013100 kg<\/td>\n4000 IU o.d.<\/td>\n5000 IU o.d.<\/td>\n4500 IU o.d.<\/td>\nNA<\/td>\n<\/tr>\n
    \u0110i\u1ec1u tr\u1ecb LMWH (non-MHV)<\/td>\n150 IU\/kg o.d.<\/td>\n200 IU\/kg o.d.<\/td>\n175 IU\/kg o.d.<\/td>\nNA<\/td>\n<\/tr>\n
    \u0110i\u1ec1u tr\u1ecb LMWH MHV<\/em><\/td>\n125 IU\/kg b.i.d. (kh\u1edfi \u0111\u1ea7u)<\/p>\n

    => 100 IU\/kg b.i.d.<\/td>\n

    		125 IU\/kg (kh\u1edfi \u0111\u1ea7u) b.i.d.<\/p>\n

    => 100 IU\/kg b.i.d.<\/td>\n

    		250 IU \/kg (kh\u1edfi \u0111\u1ea7u)<\/p>\n

    => 175 IU\/kg o.d.<\/td>\n

    		0.8\u20131.2 U\/ml anti-factor Xa<\/p>\n

    (4\u20136 h sau ti\u00eam)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u \u0111\u01b0\u1eddng u\u1ed1ng tr\u1ef1c ti\u1ebfp v\u00e0 thai k\u1ef3<\/h2>\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    DOACs ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh khi mang thai.<\/td>\nIII<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
    <\/div>\n
    \"H\u00ecnh
    H\u00ecnh 6.1. L\u1ef1a ch\u1ecdn thu\u1ed1c trong thai k\u1ef3<\/figcaption><\/figure>\n
    \"H\u00ecnh
    H\u00ecnh 6.2. L\u1ef1a ch\u1ecdn thu\u1ed1c trong giai \u0111o\u1ea1n cho con b\u00fa<\/figcaption><\/figure>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 b\u1ec7nh c\u01a1 tim v\u00e0 thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    Theo d\u00f5i tim m\u1ea1ch (ECG, si\u00eau \u00e2m tim, Holter) khuy\u1ebfn c\u00e1o trong thai k\u1ef3 \u1edf ph\u1ee5 n\u1eef b\u1ec7nh c\u01a1 tim (CMP), t\u00f9y nguy c\u01a1.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u0110\u1ebb th\u01b0\u01a1ng khuy\u1ebfn c\u00e1o \u1edf h\u1ea7u h\u1ebft ph\u1ee5 n\u1eef CMP, tr\u1eeb ch\u1ec9 \u0111\u1ecbnh s\u1ea3n khoa, suy tim n\u1eb7ng (EF <30% ho\u1eb7c NYHA III\/IV), lo\u1ea1n nh\u1ecbp kh\u00f4ng ki\u1ec3m so\u00e1t, t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng ra th\u1ea5t n\u1eb7ng (\u226550 mmHg) \u1edf HCM, ho\u1eb7c chuy\u1ec3n d\u1ea1 khi \u0111ang d\u00f9ng VKA.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ti\u1ebfp t\u1ee5c beta-blocker n\u00ean \u0111\u01b0\u1ee3c xem x\u00e9t trong thai k\u1ef3 \u1edf ph\u1ee5 n\u1eef CMP, theo d\u00f5i ph\u00e1t tri\u1ec3n thai s\u00e1t sao.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    B\u1ec7nh c\u01a1 tim th\u1ec3 gi\u00e3n (DCM)<\/strong><\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef gi\u00e3n c\u01a1 tim (DCM) c\u00f3 EF x\u1ea5u \u0111i trong thai k\u1ef3, c\u1ea7n t\u01b0 v\u1ea5n nguy c\u01a1 t\u00e1i ph\u00e1t khi mang thai sau, ngay c\u1ea3 khi EF h\u1ed3i ph\u1ee5c.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    B\u1ec7nh c\u01a1 tim th\u1ea5t ph\u1ea3i lo\u1ea1n nh\u1ecbp (ARVC)<\/strong><\/td>\n<\/tr>\n
    Flecainide (k\u1ebft h\u1ee3p beta-blocker) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc l\u00e0 thu\u1ed1c ch\u1ed1ng lo\u1ea1n nh\u1ecbp l\u1ef1a ch\u1ecdn cho ph\u1ee5 n\u1eef mang thai ARVC.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Sotalol c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef ARVC, v\u1edbi theo d\u00f5i QTc, nh\u1ecbp tim thai, nguy c\u01a1 h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft s\u01a1 sinh.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n
    B\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i (HCM)<\/strong><\/td>\n<\/tr>\n
    N\u00ean \u00e1p d\u1ee5ng ph\u00e1c \u0111\u1ed3 ph\u00e2n t\u1ea7ng nguy c\u01a1 lo\u1ea1n nh\u1ecbp th\u1ea5t nh\u01b0 \u1edf ph\u1ee5 n\u1eef HCM kh\u00f4ng mang thai.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    N\u00ean kh\u1edfi beta-blocker \u1edf ph\u1ee5 n\u1eef HCM c\u00f3 tri\u1ec7u ch\u1ee9ng do t\u1eafc ngh\u1ebdn ho\u1eb7c lo\u1ea1n nh\u1ecbp trong thai k\u1ef3.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ph\u1ee5 n\u1eef HCM c\u00f3 suy ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i (EF \u226450%) ho\u1eb7c LVOTO n\u1eb7ng (\u226550 mmHg) c\u1ea7n \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n nguy c\u01a1 cao bi\u1ebfn c\u1ed1 thai k\u1ef3.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Chuy\u1ec3n nh\u1ecbp (cardioversion) rung nh\u0129 n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef mang thai HCM.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Disopyramide c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef HCM khi l\u1ee3i \u00edch v\u01b0\u1ee3t nguy c\u01a1 co b\u00f3p t\u1eed cung<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n
    C\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf myosin kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o do thi\u1ebfu d\u1eef li\u1ec7u an to\u00e0n trong thai k\u1ef3.<\/td>\nIII<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 h\u1ed9i ch\u1ee9ng r\u1ed1i lo\u1ea1n nh\u1ecbp nguy\u00ean ph\u00e1t v\u00e0 thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    Theo d\u00f5i v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ea1 kali\/h\u1ea1 magnesa khuy\u1ebfn c\u00e1o \u1edf ph\u1ee5 n\u1eef mang thai c\u00f3 h\u1ed9i ch\u1ee9ng r\u1ed1i lo\u1ea1n nh\u1ecbp nguy\u00ean ph\u00e1t k\u00e8m n\u00f4n nhi\u1ec1u.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Long QT syndrome<\/strong><\/td>\n<\/tr>\n
    Beta-blocker (nadolol ho\u1eb7c propranolol) v\u1edbi li\u1ec1u tr\u01b0\u1edbc mang thai khuy\u1ebfn c\u00e1o trong thai k\u1ef3.<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
    Ti\u1ebfp t\u1ee5c beta-blocker trong th\u1eddi k\u1ef3 cho con b\u00fa \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 lo\u1ea1n nh\u1ecbp.<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
    Beta-blocker tr\u01b0\u1edbc mang thai (nadolol ho\u1eb7c propranolol) \u0111\u1eb7c bi\u1ec7t khuy\u1ebfn c\u00e1o \u1edf LQT2, nh\u1ea5t l\u00e0 h\u1eadu s\u1ea3n \u2013 giai \u0111o\u1ea1n nguy c\u01a1 cao<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
    Ph\u1ee5 n\u1eef mang bi\u1ebfn th\u1ec3 LQTS P\/LP nh\u01b0ng ki\u1ec3u h\u00ecnh \u00e2m t\u00ednh: c\u00e2n nh\u1eafc d\u00f9ng beta-blocker trong thai k\u1ef3, sau sinh, v\u00e0 khi cho con b\u00fa.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    C\u1eaft h\u1ea1ch giao c\u1ea3m tim tr\u00e1i c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc tr\u01b0\u1edbc mang thai \u1edf ph\u1ee5 n\u1eef nguy c\u01a1 cao kh\u00f4ng \u0111\u01b0\u1ee3c b\u1ea3o v\u1ec7 \u0111\u1ea7y \u0111\u1ee7 b\u1edfi thu\u1ed1c ho\u1eb7c ICD.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Brugada syndrome<\/strong><\/td>\n<\/tr>\n
    \u0110i\u1ec1u tr\u1ecb quinidine c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef BrS c\u00f3 bi\u1ebfn c\u1ed1 lo\u1ea1n nh\u1ecbp trong thai k\u1ef3<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Catecholaminergic polymorphic ventricular tachycardia<\/strong><\/td>\n<\/tr>\n
    Beta-blocker (nadolol, propranolol) khuy\u1ebfn c\u00e1o trong thai k\u1ef3 v\u00e0 cho con b\u00fa \u1edf ph\u1ee5 n\u1eef CPVT.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Flecainide (k\u1ebft h\u1ee3p beta-blocker) khuy\u1ebfn c\u00e1o \u1edf ph\u1ee5 n\u1eef CPVT c\u00f3 bi\u1ebfn c\u1ed1 tim nh\u01b0 ng\u1ea5t, VT, ho\u1eb7c ng\u1eebng tim trong thai k\u1ef3<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ph\u1ee5 n\u1eef CPVT \u1ed5n \u0111\u1ecbnh v\u1edbi beta-blocker + flecainide tr\u01b0\u1edbc mang thai n\u00ean ti\u1ebfp t\u1ee5c c\u1ea3 2 thu\u1ed1c trong thai k\u1ef3 v\u00e0 h\u1eadu s\u1ea3n.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    D\u00f9ng beta-blocker trong thai k\u1ef3 v\u00e0 cho con b\u00fa n\u00ean c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef mang bi\u1ebfn th\u1ec3 CPVT P\/LP nh\u01b0ng ki\u1ec3u h\u00ecnh \u00e2m t\u00ednh.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    C\u1eaft h\u1ea1ch giao c\u1ea3m tim tr\u00e1i c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc tr\u01b0\u1edbc mang thai \u1edf ph\u1ee5 n\u1eef CPVT nguy c\u01a1 cao kh\u00f4ng \u0111\u01b0\u1ee3c b\u1ea3o v\u1ec7 \u0111\u1ea7y \u0111\u1ee7 b\u1edfi thu\u1ed1c ho\u1eb7c ICD.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Short QT syndrome<\/strong><\/td>\n<\/tr>\n
    Ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb quinidine n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc trong thai k\u1ef3 v\u00e0 h\u1eadu s\u1ea3n<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Quinidine c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef SQTS c\u00f3 bi\u1ebfn c\u1ed1 lo\u1ea1n nh\u1ecbp trong thai k\u1ef3.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
    <\/div>\n
    \"H\u00ecnh
    H\u00ecnh 7. Y\u1ebfu t\u1ed1 nguy c\u01a1 v\u00e0 qu\u1ea3n l\u00fd b\u1ec7nh c\u01a1 tim chu sinh<\/figcaption><\/figure>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 b\u1ec7nh c\u01a1 tim chu s\u1ea3n (PPCM)<\/h2>\n\n\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    T\u01b0 v\u1ea5n nguy c\u01a1 t\u00e1i ph\u00e1t trong thai k\u1ef3 ti\u1ebfp theo v\u00e0 tr\u00e1nh thai \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u1edf t\u1ea5t c\u1ea3 ph\u1ee5 n\u1eef PPCM, k\u1ec3 c\u1ea3 khi EF h\u1ed3i ph\u1ee5c >50%.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    C\u00e2n nh\u1eafc b\u1ed5 sung LMWH d\u1ef1 ph\u00f2ng khi \u0111i\u1ec1u tr\u1ecb bromocriptine \u1edf ph\u1ee5 n\u1eef PPCM.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    C\u00e2n nh\u1eafc t\u01b0 v\u1ea5n v\u00e0 x\u00e9t nghi\u1ec7m di truy\u1ec1n \u1edf ph\u1ee5 n\u1eef PPCM.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    N\u1ebfu suy tim h\u1ed3i ph\u1ee5c, n\u00ean ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb t\u1ed1i thi\u1ec3u 12 th\u00e1ng sau khi EF v\u00e0 th\u1ec3 t\u00edch th\u1ea5t tr\u00e1i h\u1ed3i ph\u1ee5c ho\u00e0n to\u00e0n.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Bromocriptine c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc b\u1ed5 sung v\u00e0o \u0111i\u1ec1u tr\u1ecb suy tim t\u1ed1i \u01b0u \u0111\u1ec3 c\u1ea3i thi\u1ec7n h\u1ed3i ph\u1ee5c EF.<\/td>\nIIb<\/td>\nB<\/td>\n<\/tr>\n
    \u00c1o kh\u1eed rung tim ngo\u00e0i (WCD) c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef PPCM v\u1edbi EF <35%<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
    <\/div>\n
    \"H\u00ecnh
    H\u00ecnh 8. Ng\u01b0\u1ee1ng \u0111i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt d\u1ef1 ph\u00f2ng tr\u01b0\u1edbc mang thai \u0111\u1ed1i v\u1edbi ph\u00ecnh g\u1ed1c \u0111\u1ed9ng m\u1ea1ch ch\u1ee7\/\u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean (ph\u00eda tr\u00ean \u0111\u01b0\u1eddng k\u1ebb) v\u00e0 ph\u01b0\u01a1ng th\u1ee9c sinh \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o theo \u0111\u01b0\u1eddng k\u00ednh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 (ph\u00eda d\u01b0\u1edbi \u0111\u01b0\u1eddng k\u1ebb).<\/figcaption><\/figure>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, ph\u1eabu thu\u1eadt tim v\u00e0 thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    T\u01b0 v\u1ea5n<\/strong><\/em><\/td>\n<\/tr>\n
    Ph\u1ee5 n\u1eef b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 c\u1ea7n \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n v\u1ec1 nguy c\u01a1 tr\u01b0\u1edbc khi c\u00f3 thai v\u00e0 h\u1eadu s\u1ea3n.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ph\u1ee5 n\u1eef c\u00f3 ti\u1ec1n s\u1eed b\u00f3c t\u00e1ch\/ph\u1eabu thu\u1eadt \u0110MC c\u1ea7n t\u01b0 v\u1ea5n b\u1edfi nh\u00f3m \u0111a chuy\u00ean khoa (Pregnancy Heart Team) v\u1ec1 nguy c\u01a1 t\u00e1i ph\u00e1t: di truy\u1ec1n, b\u1ec7nh n\u1ec1n, t\u00ecnh tr\u1ea1ng \u0110MC, t\u1ed1c \u0111\u1ed9 ph\u00e1t tri\u1ec3n, bi\u1ebfn d\u1ea1ng.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ph\u1ee5 n\u1eef c\u00f3 h\u1ed9i ch\u1ee9ng Ehlers\u2013Danlos m\u1ea1ch m\u00e1u c\u00f3 \u00fd \u0111\u1ecbnh mang thai c\u1ea7n \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n nguy c\u01a1 cao bi\u1ebfn c\u1ed1 m\u1ea1ch m\u00e1u li\u00ean quan thai k\u1ef3.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    H\u00ecnh \u1ea3nh h\u1ecdc (Imaging)<\/strong><\/em><\/td>\n<\/tr>\n
    Ch\u1ee5p to\u00e0n b\u1ed9 \u0110MC (CT ho\u1eb7c CMR) khuy\u1ebfn c\u00e1o tr\u01b0\u1edbc mang thai \u1edf ph\u1ee5 n\u1eef nguy c\u01a1\/c\u00f3 b\u1ec7nh \u0110MC.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ph\u1ee5 n\u1eef c\u00f3 b\u1ec7nh \u0110MC li\u00ean quan BAV: n\u00ean si\u00eau \u00e2m tim, CT\/CMR \u0110MC \u0111\u1ecbnh k\u1ef3, \u0110MC xu\u1ed1ng \u0111\u01b0\u1ee3c kh\u1ea3o s\u00e1t khi ph\u00f9 h\u1ee3p.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ph\u1ee5 n\u1eef b\u1ec7nh \u0110MC nguy c\u01a1 th\u1ea5p (mWHO II\u2013III): 1 l\u1ea7n si\u00eau \u00e2m tim t\u1eeb 20\u201330 tu\u1ea7n v\u00e0 t\u1ea1i 6 th\u00e1ng sau sinh<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ph\u1ee5 n\u1eef b\u1ec7nh \u0110MC nguy c\u01a1 trung b\u00ecnh\u2013cao (mWHO III\u2013IV): si\u00eau \u00e2m tim m\u1ed7i 4\u201312 tu\u1ea7n (t\u00f9y m\u1ee9c \u0111\u1ed9), k\u00e9o d\u00e0i \u0111\u1ebfn 6 th\u00e1ng sau sinh<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    CMR (kh\u00f4ng gadolinium) khuy\u1ebfn c\u00e1o \u1edf ph\u1ee5 n\u1eef c\u00f3 gi\u00e3n \u0110MC ho\u1eb7c nguy c\u01a1 nh\u01b0ng ch\u01b0a c\u00f3 h\u00ecnh \u1ea3nh h\u1ecdc ti\u1ec1n thai k\u1ef3.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa<\/strong><\/em><\/td>\n<\/tr>\n
    Ph\u1ee5 n\u1eef gi\u00e3n \u0110MC\/ ti\u1ec1n s\u1eed b\u00f3c t\u00e1ch\/ bi\u1ebfn th\u1ec3 gene P\/LP khi mang thai c\u1ea7n ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p ch\u1eb7t ch\u1ebd v\u00e0 c\u00e1 th\u1ec3 h\u00f3a.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Beta-blocker khuy\u1ebfn c\u00e1o su\u1ed1t thai k\u1ef3 v\u00e0 h\u1eadu s\u1ea3n \u1edf MFS v\u00e0 HTAD kh\u00e1c.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Celiprolol khuy\u1ebfn c\u00e1o \u1edf ph\u1ee5 n\u1eef h\u1ed9i ch\u1ee9ng Ehlers\u2013Danlos m\u1ea1ch m\u00e1u khi mang thai v\u00e0 cho con b\u00fa.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ph\u1eabu thu\u1eadt \u2013 can thi\u1ec7p tr\u01b0\u1edbc mang thai<\/strong><\/em><\/td>\n<\/tr>\n
    Ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt \u0110MC g\u1ed1c\/\u0110MC l\u00ean ti\u1ec1n thai k\u1ef3 c\u1ea7n d\u1ef1a v\u00e0o h\u00ecnh th\u00e1i \u0110MC, b\u1ec7nh l\u00fd n\u1ec1n, ti\u1ec1n s\u1eed gia \u0111\u00ecnh, bi\u1ebfn th\u1ec3 gene, bi\u1ebfn c\u1ed1 m\u1ea1ch, v\u00e0 mong mu\u1ed1n b\u1ec7nh nh\u00e2n.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    C\u00e1c trung t\u00e2m qu\u1ea3n l\u00fd thai k\u1ef3 \u1edf ph\u1ee5 n\u1eef b\u1ec7nh \u0110MC nguy c\u01a1 trung b\u00ecnh\u2013cao (mWHO III\u2013IV) n\u00ean s\u1eb5n s\u00e0ng ph\u1eabu thu\u1eadt tim khi bi\u1ebfn c\u1ed1 quanh sinh.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    TH c\u1ee5 th\u1ec3<\/strong><\/em><\/td>\n<\/tr>\n
    Marfan (MFS) + \u0110MC g\u1ed1c >45mm: ph\u1eabu thu\u1eadt tr\u01b0\u1edbc mang thai.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    LDS + bi\u1ebfn th\u1ec3 P\/LP (TGFBR1\/2) + \u0110MC g\u1ed1c >45mm<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    nsHTAD + bi\u1ebfn th\u1ec3 P\/LP (MYH11, ACTA2, PRKG1, MYLK) + \u0110MC g\u1ed1c >45mm: ph\u1eabu thu\u1eadt tr\u01b0\u1edbc mang thai<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    BAV + \u0110MC g\u1ed1c\/\u0110MC l\u00ean \u226550mm ph\u1eabu thu\u1eadt tr\u01b0\u1edbc mang thai<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Kh\u00f4ng x\u00e1c \u0111\u1ecbnh bi\u1ebfn th\u1ec3 P\/LP + \u0110MC g\u1ed1c\/\u0110MC l\u00ean \u226550mm: ph\u1eabu thu\u1eadt tr\u01b0\u1edbc mang thai.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    HTAD + cung \u0110MC, \u0110MC ng\u1ef1c, \u0110MC b\u1ee5ng \u226550mm: ph\u1eabu thu\u1eadt tr\u01b0\u1edbc mang thai n\u00ean c\u00e2n nh\u1eafc.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    LDS + bi\u1ebfn th\u1ec3 P\/LP (TGFBR2, TGFB3, SMAD2\/3) + \u0110MC g\u1ed1c \u226545mm: c\u00e2n nh\u1eafc ph\u1eabu thu\u1eadt tr\u01b0\u1edbc mang thai.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    BAV + ki\u1ec3u h\u00ecnh g\u1ee3i \u00fd\/ ti\u1ec1n s\u1eed gia \u0111\u00ecnh ph\u00ecnh \u0110MC\/ b\u00f3c t\u00e1ch, \u0110MC \u226545mm: c\u00e2n nh\u1eafc ph\u1eabu thu\u1eadt tr\u01b0\u1edbc mang thai.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Kh\u00f4ng x\u00e1c \u0111\u1ecbnh bi\u1ebfn th\u1ec3 P\/LP + \u0110MC g\u1ed1c \u226545mm: c\u00e2n nh\u1eafc ph\u1eabu thu\u1eadt n\u1ebfu c\u00f3 y\u1ebfu t\u1ed1 nguy c\u01a1 (gia \u0111\u00ecnh, b\u00f3c t\u00e1ch, THA kh\u00f4ng ki\u1ec3m so\u00e1t).<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Marfan + \u0110MC g\u1ed1c 40\u201345mm: c\u00e2n nh\u1eafc ph\u1eabu thu\u1eadt tr\u01b0\u1edbc mang thai n\u1ebfu c\u00f3 y\u1ebfu t\u1ed1 nguy c\u01a1 (t\u0103ng >3mm\/n\u0103m, gia \u0111\u00ecnh, b\u00f3c t\u00e1ch).<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n
    LDS + bi\u1ebfn th\u1ec3 P\/LP (TGFBR1\/2) + \u0110MC g\u1ed1c \u226540mm: c\u00e2n nh\u1eafc ph\u1eabu thu\u1eadt tr\u01b0\u1edbc mang thai.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n
    nsHTAD + bi\u1ebfn th\u1ec3 P\/LP + \u0110MC g\u1ed1c 40\u201344mm: c\u00e2n nh\u1eafc ph\u1eabu thu\u1eadt tr\u01b0\u1edbc mang thai t\u00f9y gene, ti\u1ec1n s\u1eed gia \u0111\u00ecnh, t\u1ed1c \u0111\u1ed9 ph\u00e1t tri\u1ec3n.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n
    Sinh n\u1edf<\/strong><\/em><\/td>\n<\/tr>\n
    \u0110MC <40mm: \u0110\u1ebb th\u01b0\u1eddng<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ehlers\u2013Danlos m\u1ea1ch m\u00e1u: m\u1ed5 l\u1ea5y thai 37 tu\u1ea7n<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u0110MC 40\u201345mm: \u0111\u1ebb th\u01b0\u1eddng v\u1edbi g\u00e2y t\u00ea ngo\u00e0i m\u00e0ng c\u1ee9ng, r\u00fat ng\u1eafn giai \u0111o\u1ea1n 2<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    \u0110MC \u226545mm: c\u00e2n nh\u1eafc m\u1ed5 l\u1ea5y thai<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    B\u00f3c t\u00e1ch c\u1ea5p, b\u00e1n c\u1ea5p, m\u1ea1n: n\u00ean m\u1ed5 l\u1ea5y thai<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    \u0110MC 40\u201345mm: c\u00e2n nh\u1eafc m\u1ed5 l\u1ea5y thai<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n
    Kh\u00f4ng khuy\u1ebfn c\u00e1o d\u00f9ng ergometrine sau sinh \u1edf ph\u1ee5 n\u1eef b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/td>\nIII<\/td>\nC<\/td>\n<\/tr>\n
    Ph\u1eabu thu\u1eadt tim trong thai k\u1ef3<\/strong><\/em><\/td>\n<\/tr>\n
    Sinh tr\u01b0\u1edbc ph\u1eabu thu\u1eadt tim n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc khi thai \u0111\u00e3 c\u00f3 kh\u1ea3 n\u0103ng s\u1ed1ng, t\u00f9y tu\u1ed5i thai, b\u1ec7nh ph\u1ed1i h\u1ee3p, v\u00e0 kh\u1ea3 n\u0103ng ch\u0103m s\u00f3c s\u01a1 sinh.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Ph\u1eabu thu\u1eadt tim c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc trong thai k\u1ef3 khi th\u1ea5t b\u1ea1i v\u1edbi \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa v\u00e0 can thi\u1ec7p, ho\u1eb7c \u0111e d\u1ecda t\u00ednh m\u1ea1ng m\u1eb9.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Khuy\u1ebfn c\u00e1o qu\u1ea3n l\u00fd thai k\u1ef3 \u1edf ph\u1ee5 n\u1eef m\u1eafc b\u1ec7nh tim b\u1ea9m sinh (ACHD)<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
    ACHD<\/strong><\/td>\nNguy c\u01a1 m\u1eb9<\/strong><\/td>\nNguy c\u01a1 s\u1ea3n & thai nhi<\/strong><\/td>\nTheo d\u00f5i<\/strong><\/td>\n Qu\u1ea3n l\u00fd thai k\u1ef3 & sinh<\/strong><\/td>\n<\/tr>\n
    H\u1eb9p \u0111\u01b0\u1eddng ra th\u1ea5t tr\u00e1i (LVOTO)<\/strong><\/em><\/td>\n<\/tr>\n
    H\u1eb9p eo \u0110MC<\/td>\n\n
      \n
    • \u2191 nguy c\u01a1 bi\u1ebfn ch\u1ee9ng n\u1ebfu gradient >20mmHg, \u0110MC <21mm, tri\u1ec7u ch\u1ee9ng<\/li>\n
    • \u2191 Nguy c\u01a1 b\u00f3c t\u00e1ch \u0110MC n\u1ebfu c\u00f3 ph\u00ecnh m\u1ea1ch<\/li>\n
    • THA kh\u00f4ng ki\u1ec3m so\u00e1t.<\/li>\n<\/ul>\n<\/td>\n
    		\u2191 s\u1ea3y thai, sinh non, nh\u1eb9 c\u00e2n (9%).<\/td>\n\n
      \n
    • Theo d\u00f5i HA s\u00e1t \u2013 c\u1ea3 h\u1eadu s\u1ea3n<\/li>\n
    • CMR ti\u1ec1n thai k\u1ef3 v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng t\u1ed3n l\u01b0u.<\/li>\n<\/ul>\n<\/td>\n
    		 <\/p>\n
      \n
    • \u0110i\u1ec1u tr\u1ecb THA<\/li>\n
    • Nh\u1eadp vi\u1ec7n, \u0111\u1eb7t stent khi t\u00e1i h\u1eb9p eo n\u1eb7ng\/ \u1ea3nh h\u01b0\u1edfng m\u1eb9\u2013thai<\/li>\n
    • \u0110\u1ebb th\u01b0\u1eddng \u01b0u ti\u00ean n\u1ebfu kh\u00f4ng c\u00f3 ph\u00ecnh \u0110MC, HF, THA n\u1eb7ng.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
    H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 d\u01b0\u1edbi van, van v\u00e0 tr\u00ean van: xem M\u1ee5c 12.5.1 v\u00e0 M\u1ee5c 8.3 \u0111\u1ec3 bi\u1ebft b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 li\u00ean quan \u0111\u1ebfn BAV.
    \nPh\u1ee5 n\u1eef b\u1ecb t\u1ed5n th\u01b0\u01a1ng t\u1eafc ngh\u1ebdn tim tr\u00e1i k\u00e9o d\u00e0i c\u00f3 t\u1ef7 l\u1ec7 bi\u1ebfn c\u1ed1 tim m\u1ea1ch \u1edf m\u1eb9 cao h\u01a1n.<\/td>\n<\/tr>\n
    Shunt lesions<\/strong><\/em><\/td>\n<\/tr>\n
    ASD (th\u00f4ng li\u00ean nh\u0129)<\/td>\nNguy c\u01a1 th\u1ea5p n\u1ebfu ASD nh\u1ecf\/\u0111\u00e3 s\u1eeda, kh\u00f4ng PAH.<\/p>\n

    ASD ch\u01b0a ph\u1eabu thu\u1eadt: \u2191 lo\u1ea1n nh\u1ecbp (4%)<\/p>\n

    Tuy\u00ean t\u1eafc ngh\u1ecbch l\u00fd.<\/td>\n

    		Hi\u1ebfm: (ch\u01b0a s\u1eeda)<\/p>\n
      \n
    • SGA (21%)<\/li>\n
    • T\u1eed vong chu sinh (2\u20133%)<\/li>\n
    • Ti\u1ec1n s\u1ea3n gi\u1eadt (7%).<\/li>\n<\/ul>\n<\/td>\n
    		ASD ch\u01b0a\/\u0111\u00e3 s\u1eeda, kh\u00f4ng bi\u1ebfn ch\u1ee9ng: si\u00eau \u00e2m tim 28\u201332 tu\u1ea7n<\/td>\nASD l\u1edbn\/\u1ea3nh h\u01b0\u1edfng huy\u1ebft \u0111\u1ed9ng: \u0111\u00f3ng tr\u01b0\u1edbc mang thai.<\/p>\n

    Ch\u01b0a s\u1eeda:<\/p>\n

      \n
    • C\u00e2n nh\u1eafc ASA\/LMWH d\u1ef1 ph\u00f2ng<\/li>\n
    • \u0110\u00f3ng trong thai k\u1ef3 ch\u1ec9 khi \u0111\u1ed9t qu\u1ef5 t\u00e1i ph\u00e1t d\u00f9 \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
    VSD (th\u00f4ng li\u00ean th\u1ea5t)\/PDA<\/td>\nNguy c\u01a1 th\u1ea5p n\u1ebfu nh\u1ecf\/\u0111\u00e3 s\u1eeda, kh\u00f4ng t\u0103ng \u00e1p ph\u1ed5i.<\/td>\nKh\u00f4ng t\u0103ng nguy c\u01a1.<\/td>\nVSD ch\u01b0a\/\u0111\u00e3 s\u1eeda: si\u00eau \u00e2m tim 28\u201332 tu\u1ea7n.<\/td>\nSinh th\u01b0\u1eddng \u01b0u ti\u00ean.<\/td>\n<\/tr>\n
    AVSD (th\u00f4ng nh\u0129 th\u1ea5t)<\/td>\nNguy c\u01a1 th\u1ea5p n\u1ebfu \u0111\u00e3 s\u1eeda, kh\u00f4ng c\u00f2n t\u1ed3n l\u01b0u.<\/p>\n

    Nguy c\u01a1 lo\u1ea1n nh\u1ecbp, h\u1edf van nh\u0129 th\u1ea5t \u2191 n\u1ebfu c\u00f2n t\u1ed3n l\u01b0u.<\/p>\n

    N\u1ebfu ch\u01b0a s\u1eeda: nguy c\u01a1 thuy\u00ean t\u1eafc ngh\u1ecbch l\u00fd.<\/td>\n

    		T\u0103ng t\u1eed vong chu sinh (6%), t\u00e1i ph\u00e1t b\u1ec7nh tim b\u1ea9m sinh.<\/td>\nAVSD ch\u01b0a\/\u0111\u00e3 s\u1eeda:si\u00eau \u00e2m tim 28\u201332 tu\u1ea7n.<\/p>\n

    Nguy c\u01a1 cao n\u1ebfu h\u1edf van, PAH, \u2193 EF, \u2191 NYHA.<\/td>\n

    		N\u1ebfu c\u00f2n t\u1ed3n l\u01b0u: x\u1eed tr\u00ed nh\u01b0 ASD\/VSD.<\/p>\n

    N\u1ebfu c\u00f3 h\u1edf van nhi\u1ec1u: c\u1ea7n theo d\u00f5i \u0111\u1eb7c bi\u1ec7t.<\/p>\n

    PAH<\/td>\n<\/tr>\n

    Pulmonary valve & RVOT disease<\/strong><\/em><\/td>\n<\/tr>\n
    H\u1eb9p RVOT\/van ph\u1ed5i<\/td>\nNh\u1eb9\u2013TB: nguy c\u01a1 th\u1ea5p.<\/p>\n

    N\u1eb7ng: suy th\u1ea5t ph\u1ea3i, lo\u1ea1n nh\u1ecbp.<\/td>\n

    		Nguy c\u01a1 th\u1ea5p.<\/td>\nNh\u1eb9\u2013TB: si\u00eau \u00e2m tim 28\u201332 tu\u1ea7n.<\/p>\n

    N\u1eb7ng: si\u00eau \u00e2m tim 2 l\u1ea7n\/th\u00e1ng, t\u1eadp trung RV.<\/td>\n

    		N\u1ebfu c\u00f3 tri\u1ec7u ch\u1ee9ng \u2192 can thi\u1ec7p (nong van, thay van).<\/p>\n

    C\u00e2n nh\u1eafc m\u1ed5 l\u1ea5y thai n\u1ebfu h\u1eb9p n\u1eb7ng.<\/td>\n<\/tr>\n

    H\u1edf van ph\u1ed5i<\/td>\n\u2191 nguy c\u01a1 khi \u2193 ch\u1ee9c n\u0103ng th\u1ea5t ph\u1ea3i.<\/td>\nSinh non.<\/td>\nSi\u00eau \u00e2m tim 2 l\u1ea7n\/th\u00e1ng n\u1ebfu n\u1eb7ng k\u00e8m \u2193 ch\u1ee9c n\u0103ng th\u1ea5t ph\u1ea3i.<\/td>\n<\/td>\n<\/tr>\n
    Sau thay van ph\u1ed5i<\/td>\nNguy c\u01a1 th\u1ea5p.<\/td>\nNguy c\u01a1 th\u1ea5p.<\/td>\nSi\u00eau \u00e2m tim 28\u201332 tu\u1ea7n.<\/td>\nSinh th\u01b0\u1eddng \u01b0u ti\u00ean.<\/td>\n<\/tr>\n
    TOF \u0111\u00e3 s\u1eeda<\/strong><\/em><\/td>\n<\/tr>\n
    <\/td>\nNguy c\u01a1 th\u1ea5p n\u1ebfu kh\u00f4ng t\u1ed3n l\u01b0u.<\/p>\n

    \u2191 nguy c\u01a1 lo\u1ea1n nh\u1ecbp, suy tim (7\u201310%) n\u1ebfu h\u1edf van ph\u1ed5i, \u2193 ch\u1ee9c n\u0103ng th\u1ea5t ph\u1ea3i, RVOTO.<\/td>\n

    		15% nguy c\u01a1 bi\u1ebfn ch\u1ee9ng thai nhi v\u00e0 s\u1ea3n khoa ch\u1ee7 y\u1ebfu s\u1ea3y thai, nh\u1eb9 c\u00e2n, sinh non<\/p>\n

    T\u1ef7 l\u1ec7 t\u1eed vong thai nhi th\u1ea5p (0,7%)<\/p>\n

    Nguy c\u01a1 t\u00e1i ph\u00e1t \u1edf con n\u1ebfu h\u1ed9i ch\u1ee9ng m\u1ea5t \u0111o\u1ea1n 22q11 (50%)<\/td>\n

    		Si\u00eau \u00e2m tim \u1edf tam c\u00e1 nguy\u1ec7t I v\u00e0 28\u201332 tu\u1ea7n, theo d\u00f5i th\u00eam tu\u1ef3 thu\u1ed9c v\u00e0o t\u00ecnh tr\u1ea1ng ch\u1ee9c n\u0103ng<\/td>\nQu\u1ea3n l\u00fd suy th\u1ea5t ph\u1ea3i: ngh\u1ec9 ng\u01a1i t\u1ea1i gi\u01b0\u1eddng v\u00e0 l\u1ee3i ti\u1ec3u<\/p>\n

    Qu\u1ea3n l\u00fd lo\u1ea1n nh\u1ecbp. H\u1eb9p\/h\u1edf van ph\u1ed5i n\u1eb7ng: xem ph\u1ea7n tr\u00ean<\/p>\n

    Sinh th\u01b0\u1eddng \u01b0u ti\u00ean.<\/p>\n

    C\u00e2n nh\u1eafc m\u1ed5 l\u1ea5y thai n\u1ebfu h\u1eb9p RVOTO\/van ph\u1ed5i n\u1eb7ng.<\/td>\n<\/tr>\n

    Ebstein<\/strong><\/em><\/td>\n<\/tr>\n
    <\/td>\nT\u1ef7 l\u1ec7 MACE to\u00e0n b\u1ed9 trong ROPAC: 9,9%<\/p>\n

    Nguy c\u01a1 th\u1ea5p n\u1ebfu Ebstein n\u1eb7ng\/v\u1eeba<\/p>\n

    Nguy c\u01a1 (r\u1ea5t) cao n\u1ebfu tr\u01b0\u1edbc thai k\u1ef3 c\u00f3 suy tim do shunt nh\u0129<\/p>\n

    \u2191 nguy c\u01a1 lo\u1ea1n nh\u1ecbp do \u0111\u01b0\u1eddng d\u1eabn truy\u1ec1n ph\u1ee5<\/td>\n

    		Nguy c\u01a1 thai li\u00ean quan \u0111\u1ebfn cung l\u01b0\u1ee3ng tim th\u1ea5p:<\/p>\n
      \n
    • S\u1ea3y thai<\/li>\n
    • Sinh non (20\u201324%)<\/li>\n
    • T\u1eed vong s\u01a1 sinh (3%)<\/li>\n
    • Xu\u1ea5t huy\u1ebft sau sinh<\/li>\n
    • Nguy c\u01a1 t\u00e1i ph\u00e1t (5%).<\/li>\n<\/ul>\n<\/td>\n
    		Nh\u1eb9\u2013TB: \u0111\u00e1nh gi\u00e1 ban \u0111\u1ea7u v\u00e0 28\u201332 tu\u1ea7n b\u1eb1ng si\u00eau \u00e2m v\u00e0 ECG.<\/p>\n

    N\u1eb7ng: si\u00eau \u00e2m tim 2 l\u1ea7n\/th\u00e1ng + ECG.<\/p>\n

    Theo d\u00f5i lo\u1ea1n nh\u1ecbp n\u1ebfu c\u00f3 tri\u1ec7u ch\u1ee9ng h\u1ed3i h\u1ed9p<\/td>\n

    		H\u1edf van ba l\u00e1 n\u1eb7ng + suy tim c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa<\/p>\n

    \u0110i\u1ec1u tr\u1ecb lo\u1ea1n nh\u1ecbp k\u1ecbp th\u1eddi<\/p>\n

    C\u1ea7n t\u01b0 v\u1ea5n tr\u01b0\u1edbc thai k\u1ef3 ph\u00f9 h\u1ee3p v\u1ec1 nguy c\u01a1 MACE r\u1ea5t cao khi c\u00f3 suy tim<\/td>\n<\/tr>\n

    Transposition of the great arteries<\/strong><\/em><\/td>\n<\/tr>\n
    Chuy\u1ec3n g\u1ed1c \u0111\u1ea1i \u0111\u1ed9ng m\u1ea1ch sau ph\u1eabu thu\u1eadt chuy\u1ec3n nh\u0129 (Mustard ho\u1eb7c Senning) v\u00e0 CCTGA<\/td>\nNguy c\u01a1 thai k\u1ef3 cao t\u1ef7 l\u1ec7 MACE l\u00ean \u0111\u1ebfn 28% trong c\u00e1c nghi\u00ean c\u1ee9u h\u1ed3i c\u1ee9u. Lo\u1ea1n nh\u1ecbp nh\u0129 v\u00e0 th\u1ea5t 6,7%, suy tim 10%.<\/p>\n

    C\u00e1c lo\u1ea1n nh\u1ecbp nh\u0129 th\u01b0\u1eddng dung n\u1ea1p k\u00e9m.<\/p>\n

    H\u1eb9p t\u0129nh m\u1ea1ch ch\u1ee7 c\u00f3 th\u1ec3 g\u00e2y gi\u1ea3m oxy v\u00e0 thuy\u00ean t\u1eafc ngh\u1ecbch l\u00fd<\/p>\n

    C\u00e1c y\u1ebfu t\u1ed1 d\u1ef1 b\u00e1o MACE: tri\u1ec7u ch\u1ee9ng suy tim tr\u01b0\u1edbc thai k\u1ef3 v\u00e0 EF th\u1ea5t ph\u1ea3i <40%<\/td>\n

    		Nguy c\u01a1 thai li\u00ean quan \u0111\u1ebfn cung l\u01b0\u1ee3ng t\u00ecm m\u1eb9 v\u00e0 \u0111\u1ed9 b\u00e3o h\u00f2a oxy<\/p>\n

    Sinh non (21%)<\/p>\n

    Tr\u1ebb nh\u1eb9 c\u00e2n (18%)<\/p>\n

    T\u1eed vong thai nhi hi\u1ebfm g\u1eb7p (0,7%)<\/p>\n

    PPH, 7%.<\/td>\n

    		Theo d\u00f5i d\u1ef1a tr\u00ean t\u00ecnh tr\u1ea1ng gi\u1ea3i ph\u1eabu v\u00e0 ch\u1ee9c n\u0103ng: si\u00eau \u00e2m tim m\u1ed7i 1\u2013 3 th\u00e1ng v\u00e0 Holter \u0111i\u1ec7n tim khi c\u00f3 tri\u1ec7u ch\u1ee9ng h\u1ed3i h\u1ed9p.<\/td>\nT\u01b0 v\u1ea5n tr\u01b0\u1edbc thai k\u1ef3 v\u1ec1 nguy c\u01a1 r\u1ea5t cao n\u1ebfu NYHA class III\/IV, EF th\u1ea5t ph\u1ea3i <40%, h\u1edf van 3 l\u00e1 trung b\u00ecnh\u2013n\u1eb7ng, ho\u1eb7c suy tim \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb.<\/p>\n

    \u0110i\u1ec1u tr\u1ecb lo\u1ea1n nh\u1ecbp k\u1ecbp th\u1eddi.<\/p>\n

    C\u00e2n nh\u1eafc theo d\u00f5i sau sinh ch\u1eb7t ch\u1ebd 48\u201372h v\u00e0 theo d\u00f5i l\u00e2u d\u00e0i. \u0110\u1ebb th\u01b0\u1eddng c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc n\u1ebfu kh\u00f4ng c\u00f3 suy tim n\u1eb7ng.<\/td>\n<\/tr>\n

    Chuy\u1ec3n g\u1ed1c \u0111\u1ea1i \u0111\u1ed9ng m\u1ea1ch sau ph\u1eabu thu\u1eadt \u0111\u1ed9ng m\u1ea1ch (arterial switch)<\/td>\nNguy c\u01a1 th\u1ea5p.<\/p>\n

    Nguy c\u01a1 suy tim 2\u20134%.<\/td>\n

    		Nguy c\u01a1 bi\u1ebfn c\u1ed1 s\u1ea3n khoa v\u00e0 thai nhi th\u1ea5p.<\/td>\nSi\u00eau \u00e2m tim \u1edf tu\u1ea7n 20, t\u0103ng c\u01b0\u1eddng n\u1ebfu c\u00f3 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i, h\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 ho\u1eb7c gi\u00e3n \u0111\u1ed9ng m\u1ea1ch ch\u1ee7.<\/td>\n\u0110\u1ebb th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u01b0u ti\u00ean.<\/p>\n

    Ph\u1eabu thu\u1eadt \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 tr\u01b0\u1edbc khi mang thai n\u1ebfu \u0111\u01b0\u1eddng k\u00ednh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean >55 mm ho\u1eb7c c\u00f3 h\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 n\u1eb7ng.<\/td>\n<\/tr>\n

    Tim m\u1ed9t th\u1ea5t v\u1edbi tu\u1ea7n ho\u00e0n Fontan<\/strong><\/em><\/td>\n<\/tr>\n
    <\/td>\nNguy c\u01a1 cao trong thai k\u1ef3:<\/p>\n
      \n
    • Lo\u1ea1n nh\u1ecbp tr\u00ean th\u1ea5t (8\u201311%)<\/li>\n
    • Suy tim (4\u201314%)<\/li>\n
    • \u0110\u1ed9 b\u00e3o h\u00f2a O\u2082 <85%<\/li>\n
    • Gi\u1ea3m ch\u1ee9c n\u0103ng th\u1ea5t<\/li>\n
    • Lo\u1ea1n nh\u1ecbp<\/li>\n
    • B\u1ec7nh van tim \u0111\u00e1ng k\u1ec3<\/li>\n
    • B\u1ec7nh gan li\u00ean quan Fontan (FALD)<\/li>\n
    • NYHA III\/IV.<\/li>\n<\/ul>\n<\/td>\n
    		Nguy c\u01a1 bi\u1ebfn c\u1ed1 thai nhi r\u1ea5t cao:<\/p>\n
      \n
    • Tr\u1ebb nh\u1eb9 c\u00e2n (56%)<\/li>\n
    • S\u1ea3y thai (45\u201354%)<\/li>\n
    • Thai nh\u1ecf so v\u1edbi tu\u1ed5i thai (20\u201355%)<\/li>\n
    • Sinh non (59\u201372%)<\/li>\n
    • T\u1eed vong s\u01a1 sinh (5\u201318%).<\/li>\n<\/ul>\n

      Nguy c\u01a1 s\u1ea3n khoa:<\/p>\n

        \n
      • T\u0103ng huy\u1ebft \u00e1p (14%)<\/li>\n
      • Tu\u1ea5t huy\u1ebft sau sinh (13%).<\/li>\n<\/ul>\n<\/td>\n
    		Theo d\u00f5i d\u1ef1a tr\u00ean t\u00ecnh tr\u1ea1ng gi\u1ea3i ph\u1eabu v\u00e0 ch\u1ee9c n\u0103ng: si\u00eau \u00e2m tim m\u1ed7i 1\u2013 3 th\u00e1ng v\u00e0 x\u00e9t nghi\u1ec7m NT- proBNP n\u1ed1i ti\u1ebfp.<\/p>\n

    Theo d\u00f5i t\u1ea1i trung t\u00e2m ACHD chuy\u00ean bi\u1ec7t.<\/td>\n

    		T\u01b0 v\u1ea5n tr\u01b0\u1edbc thai k\u1ef3 v\u1ec1 nguy c\u01a1 r\u1ea5t cao, \u0111\u1eb7c bi\u1ec7t n\u1ebfu c\u00f3 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 (Sp0, th\u1ea5p, ch\u1ee9c n\u0103ng th\u1ea5t gi\u1ea3m…<\/p>\n

    Thai k\u1ef3 c\u00f3 th\u1ec3 dung n\u1ea1p \u1edf ph\u1ee5 n\u1eef \u0111\u00e3 c\u00f3 tu\u1ea7n ho\u00e0n Fontan \u1ed5n \u0111\u1ecbnh, kh\u00f4ng bi\u1ebfn ch\u1ee9ng<\/p>\n

    ASA v\u00e0\/ho\u1eb7c LMWH (t\u00f9y s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a bi\u1ebfn ch\u1ee9ng) n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc trong quy\u1ebft \u0111\u1ecbnh chung<\/p>\n

    Lo\u1ea1n nh\u1ecbp tr\u00ean th\u1ea5t c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c, c\u00f3 th\u1ec3 b\u1eb1ng s\u1ed1c \u0111i\u1ec7n.<\/p>\n

    Qu\u1ea3n l\u00fd chuy\u1ec3n d\u1ea1 sinh v\u1edbi tu\u1ea7n ho\u00e0n ph\u1ee5 thu\u1ed9c ti\u00ean g\u00e1nh:<\/p>\n

      \n
    • G\u00e2y t\u00ea ngo\u00e0i m\u00e0ng c\u1ee9ng v\u1edbi li\u1ec1u th\u1ea5p, sinh \u1edf t\u01b0 th\u1ebf nghi\u00eang tr\u00e1i,<\/li>\n
    • Ng\u01b0\u1ee1ng th\u1ea5p cho h\u1ed7 tr\u1ee3 h\u00fat\/forceps d\u00e9 r\u00fat ng\u1eafn giai \u0111o\u1ea1n 2 (gi\u00e1m Valsalva)<\/li>\n
    • Tr\u00e1nh t\u0103ng \u00e1p l\u1ef1c trong l\u1ed3ng ng\u1ef1c (n\u1ebfu c\u00f3 shunt ho\u1eb7c b\u00e0ng h\u1ec7 t\u0129nh m\u1ea1ch).<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
    ACHD ch\u01b0a s\u1eeda (kh\u00f4ng c\u00f3 t\u0103ng \u00e1p ph\u1ed5i)<\/strong><\/em><\/td>\n<\/tr>\n
    <\/td>\nSuy tim, huy\u1ebft kh\u1ed1i, lo\u1ea1n nh\u1ecbp v\u00e0 t\u1eed vong m\u1eb9 trong thai k\u1ef3 \u1edf 21%.<\/td>\nM\u1ee9c \u0111\u1ed9 thi\u1ebfu oxy m\u1eb9 l\u00e0 y\u1ebfu t\u1ed1 d\u1ef1 b\u00e1o quan tr\u1ecdng nh\u1ea5t \u0111\u1ed1i v\u1edbi k\u1ebft c\u1ee5c thai: 10% thai s\u1ed1ng n\u1ebfu SpO2 m\u1eb9 <90%, ch\u1ec9 12% thai s\u1ed1ng n\u1ebfu SpO2 m\u1eb9 <85%.<\/td>\nTheo d\u00f5i t\u1ea1i trung t\u00e2m chuy\u00ean s\u00e2u v\u1ec1 ACHD.<\/td>\nC\u1ea7n t\u01b0 v\u1ea5n tr\u01b0\u1edbc thai k\u1ef3 v\u1ec1 nguy c\u01a1 r\u1ea5t cao, \u0111\u1eb7c bi\u1ec7t n\u1ebfu \u0111\u1ed9 b\u00e3o h\u00f2a oxy m\u1eb9 l\u00fac ngh\u1ec9 <85%.<\/p>\n

    C\u00f3 th\u1ec3 c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng b\u1ed9 l\u1ecdc kh\u00ed t\u0129nh m\u1ea1ch \u0111\u1ec3 tr\u00e1nh thuy\u00ean t\u1eafc kh\u00ed.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 b\u1ec7nh tim b\u1ea9m sinh v\u00e0 thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    \u0110\u1ebb th\u01b0\u1eddng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u1edf \u0111a s\u1ed1 ph\u1ee5 n\u1eef m\u1eafc ACHD.<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
    T\u1ea5t c\u1ea3 ph\u1ee5 n\u1eef c\u00f3 tu\u1ea7n ho\u00e0n Fontan mong mu\u1ed1n mang thai n\u00ean \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n tr\u01b0\u1edbc thai k\u1ef3 b\u1edfi Pregnancy Heart Team v\u1ec1 nguy c\u01a1 r\u1ea5t cao c\u1ee7a bi\u1ebfn c\u1ed1 li\u00ean quan thai k\u1ef3.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ph\u1ee5 n\u1eef c\u00f3 b\u1ec7nh th\u1ea5t ph\u1ea3i h\u1ec7 th\u1ed1ng (Mustard\/Senning ho\u1eb7c TGA \u0111\u00e3 s\u1eeda ch\u1eefa b\u1ea9m sinh), thu\u1ed9c NYHA III\/IV, r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1ea5t h\u1ec7 th\u1ed1ng (EF <40%), ho\u1eb7c h\u1edf van 3 l\u00e1 n\u1eb7ng mong mu\u1ed1n mang thai n\u00ean \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n b\u1edfi Pregnancy Heart Team v\u1ec1 nguy c\u01a1 r\u1ea5t cao c\u1ee7a bi\u1ebfn c\u1ed1 li\u00ean quan thai k\u1ef3.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef c\u00f3 t\u1ed5n th\u01b0\u01a1ng huy\u1ebft \u0111\u1ed9ng h\u1ecdc n\u1eb7ng, th\u1ea3o lu\u1eadn v\u1ec1 c\u00e1c can thi\u1ec7p theo guideline n\u00ean \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh tr\u01b0\u1edbc khi mang thai.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 t\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i v\u00e0 thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    Ph\u1ee5 n\u1eef trong \u0111\u1ed9 tu\u1ed5i sinh \u0111\u1ebb m\u1eafc PAH mong mu\u1ed1n mang thai n\u00ean \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n b\u1edfi nh\u00f3m \u0111a chuy\u00ean khoa v\u1ec1 nguy c\u01a1 r\u1ea5t cao c\u1ee7a bi\u1ebfn c\u1ed1 li\u00ean quan thai k\u1ef3, \u0111\u1ed3ng th\u1eddi khuy\u1ebfn kh\u00edch qu\u00e1 tr\u00ecnh ra quy\u1ebft \u0111\u1ecbnh chung v\u1ec1 vi\u1ec7c c\u00f3 n\u00ean mang thai hay kh\u00f4ng.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    C\u1ea7n cung c\u1ea5p th\u00f4ng tin r\u00f5 r\u00e0ng v\u1ec1 tr\u00e1nh thai cho ph\u1ee5 n\u1eef trong \u0111\u1ed9 tu\u1ed5i sinh \u0111\u1ebb m\u1eafc PAH.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef PAH c\u1ea7n ch\u1ea5m d\u1ee9t thai k\u1ef3, khuy\u1ebfn c\u00e1o th\u1ef1c hi\u1ec7n t\u1ea1i trung t\u00e2m PH.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Th\u00f4ng tim ph\u1ea3i n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc trong thai k\u1ef3 n\u1ebfu c\u00f3 s\u1ef1 kh\u00f4ng ch\u1eafc ch\u1eafn v\u1ec1 ch\u1ea9n \u0111o\u00e1n ho\u1eb7c c\u1ea7n h\u1ed7 tr\u1ee3 c\u00e1c quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb quan tr\u1ecdng.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    C\u00e1c thu\u1ed1c \u0111\u1ed1i kh\u00e1ng th\u1ee5 th\u1ec3 endothelin, riociguat, v\u00e0 selexipag kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng trong thai k\u1ef3.<\/td>\nIII<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    L\u00fd do s\u1eed d\u1ee5ng d\u1ef1 ph\u00f2ng huy\u1ebft kh\u1ed1i trong v\u00e0 sau thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
    T\u00ecnh tr\u1ea1ng y khoa<\/strong><\/td>\nD\u1ef1 ph\u00f2ng trong thai k\u1ef3<\/strong><\/td>\nD\u1ef1 ph\u00f2ng sau sinh<\/strong><\/td>\n<\/tr>\n
    Ti\u1ec1n s\u1eed VTE kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n<\/td>\n\ud83d\udc4d<\/td>\n\ud83d\udc4d<\/td>\n<\/tr>\n
    Ti\u1ec1n s\u1eed VTE li\u00ean quan hormone<\/td>\n\ud83d\udc4d<\/td>\n\ud83d\udc4d<\/td>\n<\/tr>\n
    \u0110\u1ed9t bi\u1ebfn gen y\u1ebfu t\u1ed1 V Leiden \u0111\u1ed3ng h\u1ee3p t\u1eed<\/td>\n\ud83d\udc4d<\/td>\n\ud83d\udc4d<\/td>\n<\/tr>\n
    \u0110\u1ed9t bi\u1ebfn gen y\u1ebfu t\u1ed1 V Leiden d\u1ecb h\u1ee3p t\u1eed<\/td>\n\ud83d\udc4e\ud83c\udfff<\/td>\n\ud83d\udc4e\ud83c\udfff<\/td>\n<\/tr>\n
    \u0110\u1ed9t bi\u1ebfn gen prothrombin \u0111\u1ed3ng h\u1ee3p t\u1eed<\/td>\n\ud83d\udc4d<\/td>\n\ud83d\udc4d<\/td>\n<\/tr>\n
    \u0110\u1ed9t bi\u1ebfn gen prothrombin d\u1ecb h\u1ee3p t\u1eed<\/td>\n\ud83d\udc4e\ud83c\udfff<\/td>\n\ud83d\udc4e\ud83c\udfff<\/td>\n<\/tr>\n
    Thi\u1ebfu h\u1ee5t antithrombin<\/td>\n\ud83d\udc4d<\/td>\n\ud83d\udc4d<\/td>\n<\/tr>\n
    H\u1ed9i ch\u1ee9ng kh\u00e1ng phospholipid<\/td>\n\ud83d\udc4d<\/td>\n\ud83d\udc4d<\/td>\n<\/tr>\n
    Thi\u1ebfu h\u1ee5t protein C ho\u1eb7c S<\/td>\n\ud83d\udc4e\ud83c\udfff<\/td>\n\ud83d\udc4d<\/td>\n<\/tr>\n
    Ph\u1ed1i h\u1ee3p nhi\u1ec1u b\u1ea5t th\u01b0\u1eddng \u0111\u00f4ng m\u00e1u<\/td>\n\ud83d\udc4d<\/td>\n\ud83d\udc4d<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
    \"Hi\u0300nh
    Hi\u0300nh 9: So\u031b \u0111o\u0302\u0300 cha\u0302\u0309n \u0111oa\u0301n va\u0300 \u0111ie\u0302\u0300u tri\u0323 huye\u0302\u0301t kho\u0302\u0301i ti\u0303nh ma\u0323ch sa\u0302u khi \u0111ang mang thai<\/figcaption><\/figure>\n
    \"Hi\u0300nh
    Hi\u0300nh 10: So\u031b \u0111o\u0302\u0300 cha\u0302\u0309n \u0111oa\u0301n va\u0300 \u0111ie\u0302\u0300u tri\u0323 thuye\u0302n ta\u0306\u0301c pho\u0302\u0309i o\u031b\u0309 sa\u0309n phu\u0323 huye\u0302\u0301t \u0111o\u0323\u0302ng o\u0302\u0309n \u0111i\u0323nh (A) va\u0300 kho\u0302ng o\u0302\u0309n \u0111i\u0323nh (B)<\/figcaption><\/figure>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 b\u1ec7nh huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch trong thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef mang thai ho\u1eb7c sau sinh c\u00f3 nguy c\u01a1 cao VTE, li\u1ec1u c\u1ed1 \u0111\u1ecbnh d\u1ef1 ph\u00f2ng LMWH \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o thay v\u00ec li\u1ec1u ch\u1ec9nh theo c\u00e2n n\u1eb7ng \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 VTE.<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef mang thai ho\u1eb7c sau sinh nghi ng\u1edd c\u00f3 VTE (DVT v\u00e0\/ho\u1eb7c PE), vi\u1ec7c \u0111\u00e1nh gi\u00e1 ch\u1ea9n \u0111o\u00e1n ch\u00ednh th\u1ee9c ngay l\u1eadp t\u1ee9c v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c th\u1ef1c \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o v\u00e0 kh\u00f4ng n\u00ean tr\u00ec ho\u00e3n.<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef mang thai ho\u1eb7c sau sinh v\u1edbi ch\u1ea9n \u0111o\u00e1n m\u1edbi VTE (DVT v\u00e0\/ho\u1eb7c PE), s\u1ef1 tham gia c\u1ee7a Pregnancy Heart Team, bao g\u1ed3m c\u1ea3 chuy\u00ean gia m\u1ea1ch m\u00e1u v\u00e0 huy\u1ebft h\u1ecdc, \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef mang thai ho\u1eb7c sau sinh v\u1edbi ch\u1ea9n \u0111o\u00e1n VTE kh\u00f4ng k\u00e8m theo t\u00ecnh tr\u1ea1ng huy\u1ebft \u0111\u1ed9ng kh\u00f4ng \u1ed5n \u0111\u1ecbnh, khuy\u1ebfn c\u00e1o ch\u1ed1ng \u0111\u00f4ng b\u1eb1ng LMWH li\u1ec1u \u0111i\u1ec1u tr\u1ecb d\u1ef1a tr\u00ean c\u00e2n n\u1eb7ng \u0111\u1ea7u thai k\u1ef3.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef mang thai ho\u1eb7c sau sinh c\u00f3 nghi ng\u1edd m\u1ea1nh v\u1ec1 VTE, n\u00ean c\u00e2n nh\u1eafc kh\u1edfi tr\u1ecb b\u1eb1ng LMWH li\u1ec1u \u0111i\u1ec1u tr\u1ecb cho \u0111\u1ebfn khi VTE \u0111\u01b0\u1ee3c lo\u1ea1i tr\u1eeb ho\u1eb7c x\u00e1c nh\u1eadn.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef mang thai ho\u1eb7c sau sinh v\u1edbi ch\u1ea9n \u0111o\u00e1n PE c\u1ea5p nguy c\u01a1 cao, n\u00ean c\u00e2n nh\u1eafc chi\u1ebfn l\u01b0\u1ee3c t\u00e1i t\u01b0\u1edbi m\u00e1u qua catheter ho\u1eb7c ti\u00eau s\u1ee3i huy\u1ebft to\u00e0n th\u00e2n.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef mang thai ho\u1eb7c sau sinh v\u1edbi ch\u1ea9n \u0111o\u00e1n PE c\u1ea5p nguy c\u01a1 cao, ph\u1eabu thu\u1eadt l\u1ea5y huy\u1ebft kh\u1ed1i c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc nh\u01b0 m\u1ed9t bi\u1ec7n ph\u00e1p thay th\u1ebf cho can thi\u1ec7p qua catheter ho\u1eb7c ti\u00eau s\u1ee3i huy\u1ebft to\u00e0n th\u00e2n.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
    \"Hi\u0300nh
    Hi\u0300nh 11: Kie\u0302\u0309m soa\u0301t ti\u0300nh tra\u0323ng \u0111au ngu\u031b\u0323c khi mang thai va\u0300 06 tha\u0301ng sau sinh<\/figcaption><\/figure>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh v\u00e0 thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef mang thai c\u00f3 \u0111au ng\u1ef1c, khuy\u1ebfn c\u00e1o lo\u1ea1i tr\u1eeb c\u00e1c t\u00ecnh tr\u1ea1ng tim m\u1ea1ch nguy hi\u1ec3m t\u00ednh m\u1ea1ng, bao g\u1ed3m PE, ACS (bao g\u1ed3m SCAD), v\u00e0 h\u1ed9i ch\u1ee9ng \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 c\u1ea5p.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Qu\u1ea3n l\u00fd ph\u1ee5 n\u1eef mang thai c\u00f3 ACS \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o gi\u1ed1ng nh\u01b0 \u1edf ph\u1ee5 n\u1eef kh\u00f4ng mang thai, bao g\u1ed3m c\u1ea3 th\u0103m d\u00f2 ch\u1ea9n \u0111o\u00e1n v\u00e0 can thi\u1ec7p.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Aspirin li\u1ec1u th\u1ea5p \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o l\u00e0 thu\u1ed1c kh\u00e1ng ti\u1ec3u c\u1ea7u l\u1ef1a ch\u1ecdn trong thai k\u1ef3 v\u00e0 giai \u0111o\u1ea1n cho con b\u00fa khi ch\u1ec9 \u0111\u1ecbnh \u0111\u01a1n tr\u1ecb li\u1ec7u kh\u00e1ng ti\u1ec3u c\u1ea7u.<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
    N\u1ebfu c\u1ea7n DAPT, clopidogrel \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o l\u00e0 thu\u1ed1c \u1ee9c ch\u1ebf P2Y12 l\u1ef1a ch\u1ecdn trong thai k\u1ef3.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Th\u1eddi gian s\u1eed d\u1ee5ng DAPT (aspirin v\u00e0 clopidogrel) \u1edf ph\u1ee5 n\u1eef mang thai \u0111\u1eb7t stent \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o gi\u1ed1ng nh\u01b0 \u1edf ph\u1ee5 n\u1eef kh\u00f4ng mang thai, v\u1edbi c\u00e1ch ti\u1ebfp c\u1eadn c\u00e1 th\u1ec3 h\u00f3a d\u1ef1a tr\u00ean c\u00e2n nh\u1eafc nguy c\u01a1 thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 v\u00e0 nguy c\u01a1 ch\u1ea3y m\u00e1u li\u00ean quan sinh n\u1edf.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u0110\u1ebb th\u01b0\u1eddng n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf h\u1ea7u h\u1ebft ph\u1ee5 n\u1eef mang thai c\u00f3 ACS, t\u00f9y thu\u1ed9c v\u00e0o ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i v\u00e0 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Vi\u1ec7c ti\u1ebfp t\u1ee5c s\u1eed d\u1ee5ng statin c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc trong thai k\u1ef3 \u1edf ph\u1ee5 n\u1eef c\u00f3 b\u1ec7nh l\u00fd x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch \u0111\u00e3 x\u00e1c \u0111\u1ecbnh.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    R\u1ed1i lo\u1ea1n t\u0103ng huy\u1ebft \u00e1p trong thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n
    A. T\u0103ng huy\u1ebft \u00e1p m\u1ea1n t\u00ednh<\/strong><\/td>\n<\/tr>\n
    Huy\u1ebft \u00e1p cao \u0111\u00e3 c\u00f3 t\u1eeb tr\u01b0\u1edbc khi c\u00f3 thai ho\u1eb7c xu\u1ea5t hi\u1ec7n tr\u01b0\u1edbc 20 tu\u1ea7n tu\u1ed5i thai, th\u01b0\u1eddng t\u1ed3n t\u1ea1i sau sinh 6 tu\u1ea7n, c\u00f3 th\u1ec3 k\u00e8m theo protein ni\u1ec7u.<\/span><\/p>\n
      \n
    1. T\u0103ng huy\u1ebft \u00e1p nguy\u00ean ph\u00e1t.<\/span><\/li>\n
    2. T\u0103ng huy\u1ebft \u00e1p th\u1ee9 ph\u00e1t.<\/span><\/li>\n
    3. T\u0103ng huy\u1ebft \u00e1p \u00e1o cho\u00e0ng tr\u1eafng<\/span><\/li>\n
    4. T\u0103ng huy\u1ebft \u00e1p \u1ea9n gi\u1ea5u<\/span><\/li>\n<\/ol>\n<\/td>\n<\/tr>\n
    B. T\u0103ng huy\u1ebft \u00e1p thai k\u1ef3<\/strong><\/td>\n<\/tr>\n
    Huy\u1ebft \u00e1p cao xu\u1ea5t hi\u1ec7n sau 20 tu\u1ea7n tu\u1ed5i thai, th\u01b0\u1eddng h\u1ebft trong v\u00f2ng 6 tu\u1ea7n sau sinh<\/p>\n

    T\u0103ng huy\u1ebft \u00e1p thai k\u1ef3 kh\u00f4ng qua:<\/strong>
    \nPh\u00e1t hi\u1ec7n t\u1ea1i ph\u00f2ng kh\u00e1m nh\u01b0ng b\u00ecnh th\u01b0\u1eddng khi theo d\u00f5i huy\u1ebft \u00e1p l\u01b0u \u0111\u1ed9ng ho\u1eb7c t\u1ea1i nh\u00e0. 40% tr\u01b0\u1eddng h\u1ee3p s\u1ebd ti\u1ebfn tri\u1ec3n th\u00e0nh ti\u1ec1n s\u1ea3n gi\u1eadt ho\u1eb7c t\u0103ng huy\u1ebft \u00e1p thai k\u1ef3 th\u1eadt s\u1ef1 trong giai \u0111o\u1ea1n c\u00f2n l\u1ea1i c\u1ee7a thai k\u1ef3 \u2192 c\u1ea7n theo d\u00f5i s\u00e1t.<\/td>\n<\/tr>\n

    C. Ti\u1ec1n s\u1ea3n gi\u1eadt<\/strong><\/td>\n<\/tr>\n
    T\u0103ng huy\u1ebft \u00e1p thai k\u1ef3 k\u00e8m theo \u22651 trong s\u1ed1 c\u00e1ct\u00ecnh tr\u1ea1ng sau xu\u1ea5t hi\u1ec7n t\u1eeb 20 tu\u1ea7n thai k\u1ef3:<\/p>\n
      \n
    • Protein ni\u1ec7u (t\u1ec9 l\u1ec7 protein\/creatinin \u226530 mg\/mmol; ho\u1eb7c \u22650.3mg\/mg; ho\u1eb7c \u2265300 mg\/24h).<\/li>\n
    • Suy th\u1eadn c\u1ea5p (creatinin huy\u1ebft thanh \u226590 \u03bcmol\/L; \u22651.21 mg\/dL).<\/li>\n
    • T\u1ed5n th\u01b0\u01a1ng gan (AST\/ALT \u226540 IU\/L) v\u00e0 \u0111au h\u1ea1 s\u01b0\u1eddn ph\u1ea3i ho\u1eb7c \u0111au b\u1ee5ng dai d\u1eb3ng, men gan t\u0103ng, d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng (v\u00e0ng da, bu\u1ed3n n\u00f4n, n\u00f4n).<\/li>\n<\/ul>\n

      C\u00e1c bi\u1ebfn ch\u1ee9ng th\u1ea7n kinh (c\u01a1n co gi\u1eadt, thay \u0111\u1ed5i tri gi\u00e1c, \u0111au \u0111\u1ea7u d\u1eef d\u1ed9i, m\u1edd m\u1eaft, \u0111\u1ed9t qu\u1ef5, ph\u00f9 n\u00e3o tr\u00ean MRI).<\/p>\n

        \n
      • Bi\u1ec3u hi\u1ec7n huy\u1ebft h\u1ecdc (gi\u1ea3m ti\u1ec3u c\u1ea7u <100.000\/\u03bcL, h\u1ed9i ch\u1ee9ng HELLP, r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u).<\/li>\n
      • Ch\u1eadm ph\u00e1t tri\u1ec3n trong t\u1eed cung (IUGR) ho\u1eb7c ch\u1ec9 s\u1ed1 Doppler b\u1ea5t th\u01b0\u1eddng c\u1ee7a \u0111\u1ed9ng m\u1ea1ch t\u1eed cung\/rau thai.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
    D. T\u0103ng huy\u1ebft \u00e1p m\u1ea1n t\u00ednh k\u00e8m ti\u1ec1n s\u1ea3n gi\u1eadt ch\u1ed3ng ch\u1ea5t<\/strong><\/td>\n<\/tr>\n
    T\u0103ng huy\u1ebft \u00e1p \u0111\u00e3 c\u00f3 t\u1eeb tr\u01b0\u1edbc, nay xu\u1ea5t hi\u1ec7n th\u00eam c\u00e1c r\u1ed1i lo\u1ea1n c\u01a1 quan \u0111\u1eb7c hi\u1ec7u t\u01b0\u01a1ng th\u00edch v\u1edbi ti\u1ec1n s\u1ea3n gi\u1eadt ho\u1eb7c t\u0103ng huy\u1ebft \u00e1p n\u1eb7ng l\u00ean v\u1edbi xu\u1ea5t hi\u1ec7n protein ni\u1ec7u ho\u1eb7c
    \nc\u00e1c d\u1ea5u hi\u1ec7u m\u1edbi c\u1ee7a t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan sau 20 tu\u1ea7n thai k\u1ef3.<\/td>\n<\/tr>\n
    E. T\u0103ng huy\u1ebft \u00e1p ch\u01b0a ph\u00e2n lo\u1ea1i<\/strong><\/td>\n<\/tr>\n
    Huy\u1ebft \u00e1p cao xu\u1ea5t hi\u1ec7n sau 20 tu\u1ea7n nh\u01b0ng ch\u01b0a ph\u00e2n \u0111\u1ecbnh \u0111\u01b0\u1ee3c l\u00e0 t\u0103ng huy\u1ebft \u00e1p thai k\u1ef3 hay ti\u1ec1n s\u1ea3n gi\u1eadt. C\u1ea7n \u0111\u00e1nh gi\u00e1 l\u1ea1i trong giai \u0111o\u1ea1n sau thai k\u1ef3.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a ti\u1ec1n s\u1ea3n gi\u1eadt<\/h2>\n\n\n\n\n\n\n
    Y\u1ebfu t\u1ed1 nguy c\u01a1 cao c\u1ee7a ti\u1ec1n s\u1ea3n gi\u1eadt<\/strong><\/td>\n<\/tr>\n
    R\u1ed1i lo\u1ea1n t\u0103ng huy\u1ebft \u00e1p trong l\u1ea7n mang thai tr\u01b0\u1edbc.
    \nT\u0103ng huy\u1ebft \u00e1p m\u1ea1n t\u00ednh.
    \nB\u1ec7nh th\u1eadn m\u1ea1n.
    \n\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 1 ho\u1eb7c type 2.
    \nB\u1ec7nh t\u1ef1 mi\u1ec5n (lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng, h\u1ed9i ch\u1ee9ng kh\u00e1ng phospholipid).
    \nTh\u1ee5 tinh h\u1ed7 tr\u1ee3 trong thai k\u1ef3 hi\u1ec7n t\u1ea1i.<\/td>\n<\/tr>\n
    Y\u1ebfu t\u1ed1 nguy c\u01a1 trung b\u00ecnh c\u1ee7a ti\u1ec1n s\u1ea3n gi\u1eadt<\/strong><\/td>\n<\/tr>\n
    Ch\u01b0a sinh l\u1ea7n n\u00e0o.
    \nTu\u1ed5i m\u1eb9 \u226540.
    \nKho\u1ea3ng c\u00e1ch gi\u1eefa c\u00e1c l\u1ea7n mang thai >10 n\u0103m.
    \nBMI \u226535 kg\/m2 t\u1ea1i l\u1ea7n kh\u00e1m \u0111\u1ea7u ti\u00ean.
    \nTi\u1ec1n s\u1eed gia \u0111\u00ecnh c\u00f3 ti\u1ec1n s\u1ea3n gi\u1eadt.
    \nMang \u0111a thai<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
    \"Hi\u0300nh
    Hi\u0300nh 12A: Qua\u0309n ly\u0301 ta\u0306ng huye\u0302\u0301t a\u0301p, tie\u0302\u0300n sa\u0309n gia\u0323\u0302t ta\u0323i trung ta\u0302m ca\u0302\u0301p cu\u031b\u0301u<\/figcaption><\/figure>\n
    \"Hi\u0300nh
    Hi\u0300nh 12B: \u0110a\u0301nh gia\u0301 Protein nie\u0323\u0302u va\u0300 cha\u0302\u0309n \u0111oa\u0301n tie\u0302\u0300n sa\u0309n gia\u0323\u0302t<\/figcaption><\/figure>\n
    \"Hi\u0300nh
    Hi\u0300nh 12C: Theo do\u0303i, \u0111ie\u0302\u0300u tri\u0323 ta\u0306ng huye\u0302\u0301t a\u0301p va\u0300 tie\u0302\u0300n sa\u0309n gia\u0323\u0302t<\/figcaption><\/figure>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 r\u1ed1i lo\u1ea1n t\u0103ng huy\u1ebft \u00e1p v\u00e0 thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o duy tr\u00ec huy\u1ebft \u00e1p t\u00e2m thu <140 mmHg v\u00e0 huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng <90 mmHg \u1edf ph\u1ee5 n\u1eef mang thai.<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef mang thai c\u00f3 huy\u1ebft \u00e1p t\u00e2m thu \u2265160 mmHg ho\u1eb7c huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng \u2265110 mmHg l\u00e0 t\u00ecnh tr\u1ea1ng c\u1ea5p c\u1ee9u, c\u1ea7n \u0111i\u1ec1u tr\u1ecb ngay t\u1ea1i b\u1ec7nh vi\u1ec7n.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Aspirin li\u1ec1u th\u1ea5p (75\u2013150 mg\/ng\u00e0y) \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u1edf ph\u1ee5 n\u1eef c\u00f3 nguy c\u01a1 trung b\u00ecnh ho\u1eb7c cao ti\u1ec1n s\u1ea3n gi\u1eadt (\u00edt nh\u1ea5t 1 y\u1ebfu t\u1ed1 nguy c\u01a1 cao ho\u1eb7c \u22652 y\u1ebfu t\u1ed1 nguy c\u01a1 trung b\u00ecnh) t\u1eeb tu\u1ea7n 12\u201336\/37.<\/td>\nI<\/td>\nA<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef c\u00f3 t\u0103ng huy\u1ebft \u00e1p thai k\u1ef3, kh\u1edfi tr\u1ecb thu\u1ed1c h\u1ea1 \u00e1p \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o khi huy\u1ebft \u00e1p t\u00e2m thu \u2265140 mmHg ho\u1eb7c huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng \u226590 mmHg.<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
    Methyldopa \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p khi mang thai.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Labetalol, metoprolol v\u00e0 thu\u1ed1c ch\u1eb9n k\u00eanh canxi nh\u00f3m dihydropyridine \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o trong \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p khi mang thai.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Trong t\u0103ng huy\u1ebft \u00e1p n\u1eb7ng, \u0111i\u1ec1u tr\u1ecb b\u1eb1ng labetalol t\u0129nh m\u1ea1ch, urapidil, nicardipine, ho\u1eb7c nifedipine ng\u1eafn h\u1ea1n \u0111\u01b0\u1eddng u\u1ed1ng, ho\u1eb7c methyldopa \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u0111\u1ec3 h\u1ea1 huy\u1ebft \u00e1p c\u1ea5p. Hydralazine \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch l\u00e0 l\u1ef1a ch\u1ecdn h\u00e0ng hai.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Trong ti\u1ec1n s\u1ea3n gi\u1eadt c\u00f3 ph\u00f9 ph\u1ed5i, truy\u1ec1n t\u0129nh m\u1ea1ch nitroglycerin \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef ti\u1ec1n s\u1ea3n gi\u1eadt kh\u00f4ng c\u00f3 \u0111\u1eb7c \u0111i\u1ec3m n\u1eb7ng, khuy\u1ebfn c\u00e1o sinh \u1edf tu\u1ea7n 37.<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o sinh s\u1edbm \u1edf ph\u1ee5 n\u1eef ti\u1ec1n s\u1ea3n gi\u1eadt c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u b\u1ea5t l\u1ee3i nh\u01b0 r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u.<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
    Ph\u1ee5 n\u1eef c\u00f3 t\u0103ng huy\u1ebft \u00e1p thai k\u1ef3, khuy\u1ebfn c\u00e1o sinh \u1edf tu\u1ea7n 39.<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
    N\u00ean c\u00e2n nh\u1eafc \u0111o huy\u1ebft \u00e1p l\u01b0u \u0111\u1ed9ng ho\u1eb7c t\u1ea1i nh\u00e0 \u0111\u1ec3 lo\u1ea1i tr\u1eeb t\u0103ng huy\u1ebft \u00e1p \u00e1o cho\u00e0ng tr\u1eafng v\u00e0 t\u0103ng huy\u1ebft \u00e1p \u1ea9n gi\u1ea5u, v\u1ed1n th\u01b0\u1eddng g\u1eb7p trong thai k\u1ef3.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    \u0110o huy\u1ebft \u00e1p t\u1ea1i nh\u00e0 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c xem x\u00e9t nh\u01b0 m\u1ed9t bi\u1ec7n ph\u00e1p h\u1ed7 tr\u1ee3 \u0111\u1ec3 ph\u00e1t hi\u1ec7n t\u0103ng huy\u1ebft \u00e1p m\u1edbi xu\u1ea5t hi\u1ec7n ho\u1eb7c theo d\u00f5i ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p \u1edf ph\u1ee5 n\u1eef mang thai.<\/td>\nIIb<\/td>\nB<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
    \"Hi\u0300nh
    Hi\u0300nh 13: Ro\u0302\u0301i loa\u0323n nhi\u0323p o\u031b\u0309 phu\u0323 nu\u031b\u0303 co\u0301 thai<\/figcaption><\/figure>\n
    \"Hi\u0300nh
    Hi\u0300nh 14: Qua\u0309n ly\u0301 be\u0323\u0302nh nha\u0302n nhi\u0323p nhanh QRS he\u0323p o\u031b\u0309 phu\u0323 nu\u031b\u0303 co\u0301 thai<\/figcaption><\/figure>\n
    \"Hi\u0300nh
    Hi\u0300nh 15: Qua\u0309n ly\u0301 rung-cuo\u0302\u0300ng nhi\u0303 o\u031b\u0309 phu\u0323 nu\u031b\u0303 co\u0301 thai<\/figcaption><\/figure>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 nh\u1ecbp nhanh tr\u00ean th\u1ea5t v\u00e0 thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    X\u1eed tr\u00ed c\u1ea5p t\u00ednh SVT v\u00e0 AF<\/strong><\/em><\/td>\n<\/tr>\n
    S\u1ed1c \u0111i\u1ec7n chuy\u1ec3n nh\u1ecbp ngay l\u1eadp t\u1ee9c \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o trong \u0111i\u1ec1u tr\u1ecb c\u1ea5p SVT c\u00f3 huy\u1ebft \u0111\u1ed9ng kh\u00f4ng \u1ed5n \u0111\u1ecbnh<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    C\u00e1c nghi\u1ec7m ph\u00e1p c\u01b0\u1eddng ph\u1ebf v\u1ecb v\u00e0 adenosine t\u0129nh m\u1ea1ch \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o trong chuy\u1ec3n nh\u1ecbp c\u00e1c c\u01a1n nh\u1ecbp nhanh tr\u00ean th\u1ea5t c\u00f3 huy\u1ebft \u0111\u1ed9ng \u1ed5n \u0111\u1ecbnh.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ch\u1eb9n beta t\u0129nh m\u1ea1ch (v\u00ed d\u1ee5 metoprolol) \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o l\u00e0 l\u1ef1a ch\u1ecdn \u0111\u1ea7u tay trong ki\u1ec3m so\u00e1t t\u1ea7n s\u1ed1 th\u1ea5t c\u1ea5p \u1edf ph\u1ee5 n\u1eef mang thai c\u00f3 AF ho\u1eb7c AFL v\u1edbi LVEF b\u1ea3o t\u1ed3n v\u00e0 t\u1ea7n s\u1ed1 th\u1ea5t nhanh.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Digoxin ho\u1eb7c verapamil \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch (n\u1ebfu EF b\u1ea3o t\u1ed3n) n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc l\u1ef1a ch\u1ecdn h\u00e0ng hai ki\u1ec3m so\u00e1t t\u1ea7n s\u1ed1 th\u1ea5t ban \u0111\u1ea7u \u1edf s\u1ea3n ph\u1ee5 c\u00f3 AF\/AFL v\u00e0 t\u1ea7n s\u1ed1 th\u1ea5t nhanh.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Ibutilide ho\u1eb7c flecainide c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u0111\u1ec3 ch\u1ea5m d\u1ee9t AF v\u00e0 AFL \u1edf ph\u1ee5 n\u1eef mang thai kh\u00f4ng c\u00f3 b\u1ec7nh tim c\u1ea5u tr\u00fac.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n
    X\u1eed tr\u00ed l\u00e2u d\u00e0i SVT v\u00e0 AF<\/strong><\/em><\/td>\n<\/tr>\n
    Kh\u00e1ng \u0111\u00f4ng \u0111i\u1ec1u tr\u1ecb v\u1edbi LMWH \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o cho ph\u1ee5 n\u1eef mang thai c\u00f3 AF dai d\u1eb3ng ho\u1eb7c v\u0129nh vi\u1ec5n v\u1edbi nguy c\u01a1 thuy\u00ean t\u1eafc cao.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ch\u1eb9n beta ch\u1ecdn l\u1ecdc \u03b21 \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u0111\u1ec3 ki\u1ec3m so\u00e1t t\u1ea7n s\u1ed1 \u1edf ph\u1ee5 n\u1eef mang thai c\u00f3 AF, AFL ho\u1eb7c FAT.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ch\u1eb9n beta ch\u1ecdn l\u1ecdc \u03b21 ho\u1eb7c verapamil \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u0111\u1ec3 ph\u00f2ng ng\u1eeba SVT \u1edf ph\u1ee5 n\u1eef kh\u00f4ng c\u00f3 t\u1ed5n th\u01b0\u01a1ng ch\u1ee9c n\u0103ng th\u1ea5t tr\u00ean ECG nghi<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Flecainide ho\u1eb7c propafenone \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u0111\u1ec3 ph\u00f2ng ng\u1eeba lo\u1ea1n nh\u1ecbp \u1edf ph\u1ee5 n\u1eef mang thai c\u00f3 h\u1ed9i ch\u1ee9ng WPW<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Digoxin ho\u1eb7c verapamil n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u0111\u1ec3 ki\u1ec3m so\u00e1t t\u1ea7n s\u1ed1 th\u1ea5t \u1edf ph\u1ee5 n\u1eef mang thai c\u00f3 AF, AFL ho\u1eb7c FAT khi ch\u1eb9n beta th\u1ea5t b\u1ea1i ho\u1eb7c kh\u00f4ng dung n\u1ea1p.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Flecainide, ph\u1ed1i h\u1ee3p v\u1edbi ch\u1eb9n beta, n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u0111\u1ec3 ki\u1ec3m so\u00e1t nh\u1ecbp AF l\u00e2u d\u00e0i trong thai k\u1ef3.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Sotalol c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc trong ki\u1ec3m so\u00e1t nh\u1ecbp AF v\u00e0 AFL v\u1edbi vi\u1ec7c ki\u1ec3m so\u00e1t y\u1ebfu t\u1ed1 nguy c\u01a1 g\u00e2y lo\u1ea1n nh\u1ecbp t\u01b0\u01a1ng t\u1ef1 nh\u01b0 \u1edf ph\u1ee5 n\u1eef kh\u00f4ng mang thai<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n
    Tri\u1ec7t \u0111\u1ed1t qua catheter c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef mang thai c\u00f3 SVT t\u00e1i ph\u00e1t, tri\u1ec7u ch\u1ee9ng n\u1eb7ng k\u00e9o d\u00e0i ho\u1eb7c c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1edbi \u0111i\u1ec1u tr\u1ecb thu\u1ed1c.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
    \"Hi\u0300nh
    Hi\u0300nh 16: Qua\u0309n ly\u0301 nhanh tha\u0302\u0301t o\u031b\u0309 phu\u0323 nu\u031b\u0303 co\u0301 thai<\/figcaption><\/figure>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 nh\u1ecbp nhanh th\u1ea5t, c\u1ea5y thi\u1ebft b\u1ecb, tri\u1ec7t \u0111\u1ed1t b\u1eb1ng catheter v\u00e0 thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    S\u1ed1c \u0111i\u1ec7n chuy\u1ec3n nh\u1ecbp ngay l\u1eadp t\u1ee9c \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o cho c\u1ea3 nh\u1ecbp nhanh th\u1ea5t kh\u00f4ng \u1ed5n \u0111\u1ecbnh v\u00e0 \u1ed5n \u0111\u1ecbnh.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Thu\u1ed1c ch\u1eb9n beta ho\u1eb7c verapamil \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u0111\u1ec3 d\u1ef1 ph\u00f2ng nh\u1ecbp nhanh th\u1ea5t duy tr\u00ec v\u00f4 c\u0103n.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    N\u1ebfu ch\u1ec9 \u0111\u1ecbnh c\u1ea5y ICD, m\u00e1y t\u1ea1o nh\u1ecbp ho\u1eb7c thi\u1ebft b\u1ecb t\u00e1i \u0111\u1ed3ng b\u1ed9 tim trong thai k\u1ef3, vi\u1ec7c c\u1ea5y gh\u00e9p \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o v\u1edbi bi\u1ec7n ph\u00e1p b\u1ea3o v\u1ec7 tia x\u1ea1 t\u1ed1i \u01b0u<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede b\u1ec7nh nh\u00e2n nh\u1ecbp nhanh th\u1ea5t \u0111\u01b0\u1eddng ra th\u1ea5t ph\u1ea3i v\u00f4 c\u0103n (RVOT-VT), flecainide n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc n\u1ebfu ch\u1eb9n beta th\u1ea5t b\u1ea1i, nh\u1eb1m ng\u0103n ng\u1eeba t\u00e1i ph\u00e1t.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    \u0110\u1ec3 chuy\u1ec3n nh\u1ecbp c\u1ea5p c\u00e1c c\u01a1n nh\u1ecbp nhanh th\u1ea5t duy tr\u00ec c\u00f3 huy\u1ebft \u0111\u1ed9ng \u1ed5n \u0111\u1ecbnh trong thai k\u1ef3, n\u00ean c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng ch\u1eb9n beta \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch, adenosine (\u0111\u1ed1i v\u1edbi RVOT-VT v\u00f4 c\u0103n), verapamil (\u0111\u1ed1i v\u1edbi VT b\u00f3 fascicle), procainamide, ho\u1eb7c t\u1ea1o nh\u1ecbp th\u1ea5t v\u01b0\u1ee3t t\u1ea7n s\u1ed1 (qua \u0111i\u1ec7n c\u1ef1c ICD).<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Khi th\u1ef1c hi\u1ec7n tri\u1ec7t \u0111\u1ed1t b\u1eb1ng catheter trong thai k\u1ef3, n\u00ean c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng h\u1ec7 th\u1ed1ng l\u1eadp b\u1ea3n \u0111\u1ed3 v\u00e0 \u0111\u1ecbnh v\u1ecb kh\u00f4ng d\u00f9ng tia X.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Tri\u1ec7t \u0111\u1ed1t b\u1eb1ng catheter v\u1edbi h\u1ec7 th\u1ed1ng l\u1eadp b\u1ea3n \u0111\u1ed3 \u0111i\u1ec7n gi\u1ea3i ph\u1eabu c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc t\u1ea1i c\u00e1c trung t\u00e2m c\u00f3 kinh nghi\u1ec7m trong tr\u01b0\u1eddng h\u1ee3p nh\u1ecbp nhanh th\u1ea5t t\u00e1i ph\u00e1t, kh\u00e1ng tr\u1ecb v\u1edbi thu\u1ed1c v\u00e0\/ho\u1eb7c dung n\u1ea1p k\u00e9m, khi kh\u00f4ng c\u00f2n l\u1ef1a ch\u1ecdn n\u00e0o kh\u00e1c.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
    \"Hi\u0300nh
    Hi\u0300nh 17: Qua\u0309n ly\u0301 phu\u0323 nu\u031b\u0303 mang thai co\u0301 ma\u0301y ta\u0323o nhi\u0323p hoa\u0323\u0306c ICD<\/figcaption><\/figure>\n
    \"Hi\u0300nh
    Hi\u0300nh 18: Qua\u0309n ly\u0301 so\u0302\u0301c cu\u0309a ICD trong thai ky\u0300<\/figcaption><\/figure>\n
    \"Hi\u0300nh
    Hi\u0300nh 19: Kie\u0302\u0309m soa\u0301t ngu\u031bng tim o\u031b\u0309 phu\u0323 nu\u031b\u0303 co\u0301 thai<\/figcaption><\/figure>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 ng\u1eebng tim v\u00e0 thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    \u0110\u00e8 t\u1eed cung sang tr\u00e1i b\u1eb1ng tay li\u00ean t\u1ee5c trong qu\u00e1 tr\u00ecnh CPR \u1edf ph\u1ee5 n\u1eef mang thai (\u226520 tu\u1ea7n) b\u1ecb ng\u1eebng tim \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u0111\u1ec3 gi\u1ea3m ch\u00e8n \u00e9p \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 t\u0129nh m\u1ea1ch ch\u1ee7.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o thi\u1ebft l\u1eadp \u0111\u01b0\u1eddng truy\u1ec1n t\u0129nh m\u1ea1ch tr\u00ean c\u01a1 ho\u00e0nh \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o li\u1ec7u ph\u00e1p t\u0129nh m\u1ea1ch kh\u00f4ng b\u1ecb c\u1ea3n tr\u1edf b\u1edfi t\u1eed cung c\u00f3 thai.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o th\u1ef1c hi\u1ec7n \u00e9p tim v\u00e0 s\u1ed1c \u0111i\u1ec7n kh\u1eed rung gi\u1ed1ng nh\u01b0 \u1edf ph\u1ee5 n\u1eef kh\u00f4ng mang thai<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o \u0111\u1eb7t \u0111i\u1ec7n c\u1ef1c s\u1ed1c \u0111i\u1ec7n \u1edf v\u1ecb tr\u00ed tr\u01b0\u1edbc \u2013 b\u00ean, v\u1edbi b\u1ea3n c\u1ef1c b\u00ean \u0111\u1eb7t d\u01b0\u1edbi v\u00fa.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o kh\u00f4ng ng\u1eebng b\u1ea5t k\u1ef3 thu\u1ed1c n\u00e0o \u1edf ph\u1ee5 n\u1eef mang thai b\u1ecb ng\u1eebng tim do lo ng\u1ea1i t\u00ednh g\u00e2y qu\u00e1i thai.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    M\u1ed5 l\u1ea5y thai ngay t\u1ea1i ch\u1ed7 ng\u1eebng tim n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc v\u00e0 chu\u1ea9n b\u1ecb ngay l\u1eadp t\u1ee9c n\u1ebfu kh\u00f4ng \u0111\u1ea1t \u0111\u01b0\u1ee3c ROSC \u1edf ng\u01b0\u1eddi m\u1eb9 sau 4 ph\u00fat h\u1ed3i s\u1ee9c, v\u00e0 thai nhi c\u00f2n kh\u1ea3 n\u0103ng s\u1ed1ng, d\u1ef1a v\u00e0o tu\u1ed5i thai, b\u1ec7nh \u0111i k\u00e8m, v\u00e0 m\u1ee9c \u0111\u1ed9 ch\u0103m s\u00f3c y t\u1ebf s\u1eb5n c\u00f3.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Khuy\u1ebfn c\u00e1o cho b\u1ec7nh nh\u00e2n block nh\u0129 th\u1ea5t b\u1ea9m sinh v\u00e0 ph\u1ee5 n\u1eef mang thai<\/h2>\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef mang thai c\u00f3 block nh\u0129 th\u1ea5t b\u1ea9m sinh kh\u00f4ng tri\u1ec7u ch\u1ee9ng, gi\u1ea3i ph\u1eabu v\u00e0 ch\u1ee9c n\u0103ng tim b\u00ecnh th\u01b0\u1eddng, ph\u1ee9c b\u1ed9 QRS h\u1eb9p v\u00e0 t\u1ea7n s\u1ed1 th\u1ea5t (\u2265 50 ck\/ph\u00fat), vi\u1ec7c c\u1ea5y m\u00e1y t\u1ea1o nh\u1ecbp t\u1ea1m th\u1eddi d\u1ef1 ph\u00f2ng trong l\u00fac sinh kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o.<\/td>\nIII<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 b\u1ec7nh van tim nguy\u00ean ph\u00e1t v\u00e0 thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    Can thi\u1ec7p \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o tr\u01b0\u1edbc thai k\u1ef3 \u1edf b\u1ec7nh nh\u00e2n c\u00f3 h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 n\u1eb7ng c\u00f3 tri\u1ec7u ch\u1ee9ng.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Can thi\u1ec7p \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o tr\u01b0\u1edbc thai k\u1ef3 \u1edf ph\u1ee5 n\u1eef c\u00f3 h\u1eb9p van hai l\u00e1 v\u1edbi di\u1ec7n t\u00edch van <1,5 cm2<\/sup>.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef mang thai c\u00f3 h\u1eb9p van hai l\u00e1 c\u00f3 tri\u1ec7u ch\u1ee9ng ho\u1eb7c t\u0103ng \u00e1p ph\u1ed5i, khuy\u1ebfn c\u00e1o h\u1ea1n ch\u1ebf ho\u1ea1t \u0111\u1ed9ng v\u00e0 s\u1eed d\u1ee5ng thu\u1ed1c ch\u1eb9n beta.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef mang thai c\u00f3 h\u1eb9p van hai l\u00e1, thu\u1ed1c l\u1ee3i ti\u1ec3u \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o khi tri\u1ec7u ch\u1ee9ng sung huy\u1ebft v\u1eabn t\u1ed3n t\u1ea1i d\u00f9 \u0111\u00e3 d\u00f9ng ch\u1eb9n beta.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ch\u1ed1ng \u0111\u00f4ng li\u1ec1u \u0111i\u1ec1u tr\u1ecb \u0111\u1ea7y \u0111\u1ee7 \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u1edf ph\u1ee5 n\u1eef mang thai c\u00f3 h\u1eb9p van hai l\u00e1 k\u00e8m AF, huy\u1ebft kh\u1ed1i nh\u0129 tr\u00e1i ho\u1eb7c ti\u1ec1n s\u1eed t\u1eafc m\u1ea1ch.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ph\u1eabu thu\u1eadt \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o tr\u01b0\u1edbc thai k\u1ef3 \u1edf ph\u1ee5 n\u1eef c\u00f3 h\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 ho\u1eb7c h\u1edf van hai l\u00e1 n\u1eb7ng k\u00e8m tri\u1ec7u ch\u1ee9ng, r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1ea5t ho\u1eb7c gi\u00e3n th\u1ea5t r\u00f5 r\u1ec7t.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Thu\u1ed1c l\u1ee3i ti\u1ec3u \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u1edf ph\u1ee5 n\u1eef mang thai c\u00f3 t\u1ed5n th\u01b0\u01a1ng h\u1edf van khi xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng ho\u1eb7c d\u1ea5u hi\u1ec7u sung huy\u1ebft.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Can thi\u1ec7p n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc tr\u01b0\u1edbc thai k\u1ef3 \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 n\u1eb7ng nh\u01b0ng kh\u00f4ng tri\u1ec7u ch\u1ee9ng, sau khi t\u01b0 v\u1ea5n v\u1ec1 nguy c\u01a1 v\u00e0 l\u1ee3i \u00edch.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Nong van hai l\u00e1 qua da (commissurotomy) n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef mang thai c\u00f3 tri\u1ec7u ch\u1ee9ng n\u1eb7ng ho\u1eb7c \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i t\u00e2m thu >50 mmHg b\u1ea5t ch\u1ea5p \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Ph\u1eabu thu\u1eadt van trong thai k\u1ef3 ch\u1ec9 n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc khi c\u00f3 nguy c\u01a1 t\u1eed vong cho m\u1eb9 v\u00e0 c\u00e1c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb kh\u00e1c \u0111\u00e3 th\u1ea5t b\u1ea1i<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede nh\u1eefng ph\u1ee5 n\u1eef mang thai c\u00f3 tri\u1ec7u ch\u1ee9ng \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn k\u1ef9 c\u00e0ng, h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 n\u1eb7ng kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa, c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc nong van ho\u1eb7c thay van qua da (TAVI).<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
    \"Hi\u0300nh
    Hi\u0300nh 20: Be\u0323\u0302nh ly\u0301 van tim o\u031b\u0309 phu\u0323 nu\u031b\u0303 co\u0301 thai<\/figcaption><\/figure>\n
    \"Hi\u0300nh
    Hi\u0300nh 21: Qua\u0309n ly\u0301 thuo\u0302\u0301c cho\u0302\u0301ng \u0111o\u0302ng trong ca\u0301c giai \u0111oa\u0323n cu\u0309a thai ky\u0300 o\u031b\u0309 phu\u0323 nu\u031b\u0303 co\u0301 van tim co\u031b ho\u0323c<\/figcaption><\/figure>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 van tim nh\u00e2n t\u1ea1o v\u00e0 thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    Van sinh h\u1ecdc \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o (h\u01a1n van c\u01a1 h\u1ecdc) \u1edf ph\u1ee5 n\u1eef tr\u1ebb c\u1ea7n thay van tim v\u00e0 mong mu\u1ed1n mang thai.<\/td>\nI<\/td>\nB<\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o l\u1ef1a ch\u1ecdn lo\u1ea1i ph\u1eabu thu\u1eadt ho\u1eb7c can thi\u1ec7p thay van cho ph\u1ee5 n\u1eef mong mu\u1ed1n mang thai n\u00ean \u0111\u01b0\u1ee3c th\u1ea3o lu\u1eadn c\u00f9ng Pregnancy Heart Team.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Ph\u1ee5 n\u1eef c\u00f3 van tim c\u01a1 h\u1ecdc<\/strong><\/em><\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o c\u00f3 k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb ch\u1ed1ng \u0111\u00f4ng \u0111\u01b0\u1ee3c th\u1ed1ng nh\u1ea5t t\u1eeb tr\u01b0\u1edbc (bao g\u1ed3m quy\u1ebft \u0111\u1ecbnh ti\u1ebfp t\u1ee5c VKA hay chuy\u1ec3n sang LMWH li\u1ec1u \u0111i\u1ec1u tr\u1ecb trong tam c\u00e1 nguy\u1ec7t \u0111\u1ea7u) cho ph\u1ee5 n\u1eef trong \u0111\u1ed9 tu\u1ed5i sinh \u0111\u1ebb c\u00f3 MHV tr\u01b0\u1edbc thai k\u1ef3 ho\u1eb7c ngay khi ph\u00e1t hi\u1ec7n c\u00f3 thai.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o ph\u1ee5 n\u1eef mang thai c\u00f3 MHV n\u00ean \u0111\u01b0\u1ee3c qu\u1ea3n l\u00fd b\u1edfi Pregnancy Heart Team.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef mang thai d\u00f9ng VKA, khuy\u1ebfn c\u00e1o theo d\u00f5i INR h\u00e0ng tu\u1ea7n ho\u1eb7c \u00edt nh\u1ea5t m\u1ed7i 2 tu\u1ea7n<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef mang thai c\u00f3 MHV \u0111ang d\u00f9ng LMWH li\u1ec1u \u0111i\u1ec1u tr\u1ecb, khuy\u1ebfn c\u00e1o ki\u1ec3m tra n\u1ed3ng \u0111\u1ed9 anti-Xa \u0111\u1ec9nh v\u00e0 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u theo m\u1ee5c ti\u00eau d\u1ef1a tr\u00ean nguy c\u01a1 c\u00e1 th\u1ec3 h\u00f3a.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Trong tam c\u00e1 nguy\u1ec7t th\u1ee9 hai v\u00e0 ba cho \u0111\u1ebfn tu\u1ea7n 36, vi\u1ec7c ti\u1ebfp t\u1ee5c VKA n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef c\u00f3 van tim c\u01a1 h\u1ecdc c\u00f3 nguy c\u01a1 huy\u1ebft kh\u1ed1i cao.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Trong tam c\u00e1 nguy\u1ec7t th\u1ee9 hai v\u00e0 ba, vi\u1ec7c ti\u1ebfp t\u1ee5c LMWH c\u00f9ng theo d\u00f5i anti-Xa v\u00e0 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf ph\u1ee5 n\u1eef c\u00f3 nguy c\u01a1 huy\u1ebft kh\u1ed1i th\u1ea5p h\u01a1n.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n
    LMWH kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o khi kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng theo d\u00f5i n\u1ed3ng \u0111\u1ed9 anti-Xa.<\/td>\nIII<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
    \"Hi\u0300nh
    Hi\u0300nh 22: Qua\u0309n ly\u0301 Suy tim ca\u0302\u0301p va\u0300 shock tim trong thai ki\u0300 to\u031b\u0301i 06 tha\u0301ng sau sinh<\/figcaption><\/figure>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 suy tim m\u1ea1n v\u00e0 c\u1ea5p trong thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    Suy tim m\u1ea1n<\/strong><\/em><\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o t\u01b0 v\u1ea5n cho ph\u1ee5 n\u1eef c\u00f3 HFrEF v\u1ec1 nguy c\u01a1 suy gi\u1ea3m ch\u1ee9c n\u0103ng tim trong thai k\u1ef3 v\u00e0 giai \u0111o\u1ea1n quanh sinh.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef mang thai c\u00f3 HFrEF, khuy\u1ebfn c\u00e1o chuy\u1ec3n t\u1eeb ch\u1eb9n beta kh\u00f4ng ch\u1ecdn l\u1ecdc sang ch\u1eb9n beta ch\u1ecdn l\u1ecdc \u03b21 (metoprolol, bisoprolol) k\u00e8m theo theo d\u00f5i m\u1eb9 v\u00e0 thai ch\u1eb7t ch\u1ebd.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o d\u00f9ng LMWH li\u1ec1u \u0111i\u1ec1u tr\u1ecb \u1edf ph\u1ee5 n\u1eef mang thai c\u00f3 huy\u1ebft kh\u1ed1i trong bu\u1ed3ng tim ho\u1eb7c r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i v\u1edbi EF <35%.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o t\u1ed1i \u01b0u h\u00f3a \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa theo guideline sau sinh, c\u00f3 t\u00ednh \u0111\u1ebfn c\u00e1c thu\u1ed1c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh trong th\u1eddi k\u1ef3 cho con b\u00fa<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Do nhu c\u1ea7u chuy\u1ec3n h\u00f3a cao trong th\u1eddi k\u1ef3 cho con b\u00fa, c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc ng\u1eebng cho con b\u00fa \u1edf ph\u1ee5 n\u1eef c\u00f3 suy tim n\u1eb7ng.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n
    C\u00e1c thu\u1ed1c ACEi, ARB, ARNI, MRA, ivabradin v\u00e0 SGLT2i kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o trong thai k\u1ef3 do t\u00e1c d\u1ee5ng b\u1ea5t l\u1ee3i tr\u00ean thai nhi.<\/td>\nIII<\/td>\nC<\/td>\n<\/tr>\n
    Suy tim c\u1ea5p<\/strong><\/em><\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o d\u00f9ng thu\u1ed1c t\u0103ng co b\u00f3p v\u00e0\/ho\u1eb7c thu\u1ed1c v\u1eadn m\u1ea1ch \u1edf ph\u1ee5 n\u1eef mang thai c\u00f3 s\u1ed1c tim, v\u1edbi levosimendan, dobutamine v\u00e0 milrinone l\u00e0 nh\u1eefng thu\u1ed1c \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o m\u1ed5 l\u1ea5y thai c\u1ea5p c\u1ee9u \u1edf ph\u1ee5 n\u1eef mang thai c\u00f3 s\u1ed1c tim ngay khi thai nhi c\u00f2n kh\u1ea3 n\u0103ng s\u1ed1ng, t\u00f9y theo tu\u1ed5i thai, b\u1ec7nh \u0111i k\u00e8m v\u00e0 m\u1ee9c \u0111\u1ed9 ch\u0103m s\u00f3c y t\u1ebf s\u1eb5n c\u00f3.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o chuy\u1ec3n s\u1edbm ph\u1ee5 n\u1eef mang thai b\u1ecb s\u1ed1c tim \u0111\u1ebfn c\u01a1 s\u1edf c\u00f3 h\u1ed7 tr\u1ee3 tu\u1ea7n ho\u00e0n c\u01a1 h\u1ecdc.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    C\u00f3 th\u1ec3 c\u00e2n nh\u1eafc ng\u1eebng cho con b\u00fa \u1edf ph\u1ee5 n\u1eef c\u00f3 suy tim n\u1eb7ng do nhu c\u1ea7u chuy\u1ec3n h\u00f3a cao trong th\u1eddi k\u1ef3 cho con b\u00fa.<\/td>\nIIb<\/td>\nB<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 gh\u00e9p tim v\u00e0 thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o ho\u00e3n mang thai \u00edt nh\u1ea5t 1 n\u0103m sau gh\u00e9p tim, c\u00f3 t\u00ednh \u0111\u1ebfn y\u1ebfu t\u1ed1 nguy c\u01a1 c\u00e1 nh\u00e2n.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef \u0111\u00e3 gh\u00e9p tim, khuy\u1ebfn c\u00e1o theo d\u00f5i n\u1ed3ng \u0111\u1ed9 thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch trong thai k\u1ef3 m\u1ed7i 4 tu\u1ea7n cho \u0111\u1ebfn tu\u1ea7n 32, sau \u0111\u00f3 m\u1ed7i 2 tu\u1ea7n cho \u0111\u1ebfn tu\u1ea7n 36, r\u1ed3i h\u00e0ng tu\u1ea7n cho \u0111\u1ebfn khi sinh, v\u00e0 6\u201312 th\u00e1ng sau sinh \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o theo d\u00f5i kh\u00e1ng th\u1ec3 kh\u00e1ng \u0111\u1eb7c hi\u1ec7u ng\u01b0\u1eddi cho h\u00e0ng tu\u1ea7n \u00edt nh\u1ea5t trong 6\u201312 th\u00e1ng sau sinh.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    X\u00e9t nghi\u1ec7m HLA c\u1ee7a cha tr\u01b0\u1edbc khi th\u1ee5 thai n\u00ean \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc do nguy c\u01a1 ph\u00e1t tri\u1ec3n kh\u00e1ng th\u1ec3 \u0111\u1eb7c hi\u1ec7u v\u1edbi ng\u01b0\u1eddi cho.<\/td>\nIIa<\/td>\nC<\/td>\n<\/tr>\n
    Mycophenolic acid kh\u00f4ng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o trong thai k\u1ef3 v\u00e0 c\u1ea7n ng\u1eebng \u00edt nh\u1ea5t 6 tu\u1ea7n tr\u01b0\u1edbc khi th\u1ee5 thai.<\/td>\nIII<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 ung th\u01b0-tim m\u1ea1ch v\u00e0 thai k\u1ef3<\/h2>\n\n\n\n\n\n
    Recommendations<\/strong><\/td>\nClass<\/strong><\/td>\nLevel<\/strong><\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o ph\u1ee5 n\u1eef mang thai m\u1eafc ung th\u01b0 c\u1ea7n h\u00f3a tr\u1ecb c\u00f3 \u0111\u1ed9c t\u00ednh tim \u0111\u01b0\u1ee3c qu\u1ea3n l\u00fd ph\u1ed1i h\u1ee3p b\u1edfi Pregnancy Heart Team v\u00e0 Oncology-Cardiology team.<\/td>\nI<\/td>\nC<\/td>\n<\/tr>\n
    Troponin tim v\u00e0 c\u00e1c ch\u1ec9 d\u1ea5u NP c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u0111o n\u1ec1n v\u00e0 trong qu\u00e1 tr\u00ecnh h\u00f3a tr\u1ecb anthracycline \u1edf ph\u1ee5 n\u1eef mang thai b\u1ecb ung th\u01b0.<\/td>\nIIb<\/td>\nC<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
    \"Hi\u0300nh
    Hi\u0300nh 23: Tie\u0302\u0301p ca\u0323\u0302n \u0111a hu\u031bo\u031b\u0301ng kie\u0302\u0309m soa\u0301t bie\u0302\u0301n co\u0302\u0301 ba\u0302\u0301t lo\u031b\u0323i thai ki\u0300<\/figcaption><\/figure>\n
    \"Hi\u0300nh
    Hi\u0300nh 24: So\u031b \u0111o\u0302\u0300 qua\u0309n ly\u0301 ta\u0306ng huye\u0302\u0301t a\u0301p sau sinh mo\u031b\u0301i xua\u0302\u0301t hie\u0323\u0302n<\/figcaption><\/figure>\n
    \"Hi\u0300nh
    Hi\u0300nh 25: So\u031b \u0111o\u0302\u0300 qua\u0309n ly\u0301 bie\u0302\u0301n co\u0302\u0301 sau sinh<\/figcaption><\/figure>\n

    Khuy\u1ebfn c\u00e1o v\u1ec1 h\u1eadu qu\u1ea3 l\u00e2u d\u00e0i c\u1ee7a bi\u1ebfn c\u1ed1 b\u1ea5t l\u1ee3i trong thai k\u1ef3<\/h2>\n\n\n\n\n\n\n\n\n\n\n
    Recommendations<\/span><\/td>\nClass<\/span><\/td>\nLevel<\/span><\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o \u0111\u00e1nh gi\u00e1 nguy c\u01a1 tim m\u1ea1ch \u1edf ph\u1ee5 n\u1eef c\u00f3 APO (adverse pregnancy outcomes), ghi nh\u1eadn v\u00e0 b\u00e1o c\u00e1o APO khi \u0111\u00e1nh gi\u00e1 nguy c\u01a1 CVD, \u0111\u1ed3ng th\u1eddi t\u01b0 v\u1ea5n thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh nh\u1eb1m t\u1ed1i \u01b0u s\u1ee9c kh\u1ecfe tim m\u1ea1ch.<\/span><\/td>\nI<\/span><\/td>\nB<\/span><\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef c\u00f3 t\u0103ng huy\u1ebft \u00e1p sau sinh k\u00e9o d\u00e0i t\u1eeb 6 tu\u1ea7n \u0111\u1ebfn 3 th\u00e1ng, khuy\u1ebfn c\u00e1o b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb h\u1ea1 \u00e1p, l\u01b0u \u00fd t\u00ecnh tr\u1ea1ng cho con b\u00fa, theo khuy\u1ebfn c\u00e1o hi\u1ec7n h\u00e0nh.<\/span><\/td>\nI<\/span><\/td>\nB<\/span><\/td>\n<\/tr>\n
    Trong tr\u01b0\u1eddng h\u1ee3p thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng \u0111\u01a1n thu\u1ea7n kh\u00f4ng \u0111\u1ee7 ki\u1ec3m so\u00e1t glucose sau sinh, khuy\u1ebfn c\u00e1o b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa theo khuy\u1ebfn c\u00e1o hi\u1ec7n h\u00e0nh.<\/span><\/td>\nI<\/span><\/td>\nC<\/span><\/td>\n<\/tr>\n
    Khuy\u1ebfn c\u00e1o ph\u1ee5 n\u1eef c\u00f3 ti\u1ec1n s\u1eed \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng thai k\u1ef3 n\u00ean l\u00e0m nghi\u1ec7m ph\u00e1p dung n\u1ea1p glucose (oGTT) ch\u00ednh th\u1ee9c 6\u201312 tu\u1ea7n sau sinh, l\u1eb7p l\u1ea1i sau 6\u201312 th\u00e1ng v\u00e0 theo d\u00f5i h\u1eb1ng n\u0103m \u0111\u1ec3 t\u1ea7m so\u00e1t \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng.<\/span><\/td>\nI<\/span><\/td>\nC<\/span><\/td>\n<\/tr>\n
    Nifedipine v\u00e0 labetalol (metoprolol n\u1ebfu kh\u00f4ng c\u00f3 labetalol) \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p sau sinh kh\u00f4ng bi\u1ebfn ch\u1ee9ng trong 6 tu\u1ea7n \u0111\u1ea7u sau sinh.<\/span><\/td>\nI<\/span><\/td>\nC<\/span><\/td>\n<\/tr>\n
    \u1ede ph\u1ee5 n\u1eef c\u00f3 ti\u1ec1n s\u1eed b\u1ea5t k\u1ef3 APO n\u00e0o, khuy\u1ebfn c\u00e1o \u0111\u00e1nh gi\u00e1 nguy c\u01a1 tim m\u1ea1ch t\u1ea1i 3 th\u00e1ng sau sinh, l\u1eb7p l\u1ea1i sau 6\u201312 th\u00e1ng sau khi th\u1ef1c hi\u1ec7n can thi\u1ec7p l\u1ed1i s\u1ed1ng ph\u00f9 h\u1ee3p, v\u00e0 theo d\u00f5i l\u00e2u d\u00e0i h\u1eb1ng n\u0103m.<\/span><\/td>\nIIa<\/span><\/td>\nC<\/span><\/td>\n<\/tr>\n
    C\u00f3 th\u1ec3 c\u00e2n nh\u1eafc duy tr\u00ec cho con b\u00fa nh\u1eb1m gi\u1ea3m nguy c\u01a1 tim m\u1ea1ch v\u1ec1 sau \u1edf ph\u1ee5 n\u1eef c\u00f3 ti\u1ec1n s\u1eed APO<\/span><\/td>\nIIb<\/span><\/td>\nC<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n","protected":false},"excerpt":{"rendered":"

    Nh\u00f3m bi\u00ean d\u1ecbch: 1. Khoa N\u1ed9i Tim m\u1ea1ch \u2013 Vi\u1ec7n Tim m\u1ea1ch \u2013 B\u1ec7nh vi\u1ec7n Trung \u01b0\u01a1ng Qu\u00e2n \u0111\u1ed9i 108 2. BS L\u00ea \u0110\u1ea1i Phong \u2013 B\u1ec7nh vi\u1ec7n T\u01afQ\u0110 108 3. PGS.TS Ph\u1ea1m Tr\u01b0\u1eddng S\u01a1n \u2013 B\u1ec7nh vi\u1ec7n T\u01afQ\u0110 108 ESC Guidelines for the management of CVD and pregnancy Authors\/Task Force Members: Julie De Backer […]\n","protected":false},"author":1,"featured_media":137089,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-137074","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/137074","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=137074"}],"version-history":[{"count":21,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/137074\/revisions"}],"predecessor-version":[{"id":138306,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/137074\/revisions\/138306"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/137089"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=137074"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=137074"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=137074"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}