{"id":146665,"date":"2025-10-30T16:44:23","date_gmt":"2025-10-30T09:44:23","guid":{"rendered":"https:\/\/vnras.com\/drug\/?p=146665"},"modified":"2025-10-30T16:45:03","modified_gmt":"2025-10-30T09:45:03","slug":"me-co-nhom-mau-rh-am","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/me-co-nhom-mau-rh-am\/","title":{"rendered":"CON C\u1ee6A M\u1eb8 C\u00d3 NH\u00d3M M\u00c1U RH \u00c2M"},"content":{"rendered":"<h2>Nh\u00f3m m\u00e1u RH \u00e2m l\u00e0 g\u00ec?<\/h2>\n<p>T\u1ebf b\u00e0o h\u1ed3ng c\u1ea7u c\u1ee7a ng\u01b0\u1eddi mang nhi\u1ec1u lo\u1ea1i kh\u00e1ng nguy\u00ean tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a ch\u00fang. Trong s\u1ed1 \u0111\u00f3, h\u1ec7 nh\u00f3m m\u00e1u ABO v\u00e0 Rh l\u00e0 hai th\u1ee9 quan tr\u1ecdng nh\u1ea5t. Trong Rh, kh\u00e1ng nguy\u00ean D l\u00e0 kh\u00e1ng nguy\u00ean quan tr\u1ecdng nh\u1ea5t. Nh\u1eefng ng\u01b0\u1eddi c\u00f3 kh\u00e1ng nguy\u00ean Rhesus D (RhD) \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 RhD d\u01b0\u01a1ng t\u00ednh, trong khi nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng c\u00f3 kh\u00e1ng nguy\u00ean n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 RhD \u00e2m t\u00ednh.<\/p>\n<p>Trong thai k\u1ef3, m\u1ed9t l\u01b0\u1ee3ng nh\u1ecf m\u00e1u c\u1ee7a thai nhi c\u00f3 th\u1ec3 x\u00e2m nh\u1eadp v\u00e0o tu\u1ea7n ho\u00e0n c\u1ee7a ng\u01b0\u1eddi m\u1eb9, hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 xu\u1ea5t huy\u1ebft m\u1eb9 &#8211; thai nhi (FMH &#8211; feto-maternal haemorrhage). S\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a t\u1ebf b\u00e0o m\u00e1u RhD d\u01b0\u01a1ng t\u00ednh c\u1ee7a thai nhi trong tu\u1ea7n ho\u00e0n c\u1ee7a ng\u01b0\u1eddi m\u1eb9 RhD \u00e2m t\u00ednh c\u00f3 th\u1ec3 k\u00edch th\u00edch h\u1ec7 mi\u1ec5n d\u1ecbch c\u1ee7a m\u1eb9, d\u1eabn \u0111\u1ebfn vi\u1ec7c h\u1ec7 mi\u1ec5n d\u1ecbch s\u1ea3n xu\u1ea5t kh\u00e1ng th\u1ec3, \u0111\u1ed3ng th\u1eddi t\u1ea1o ra m\u1ed9t l\u01b0\u1ee3ng kh\u00e1ng th\u1ec3 ch\u1ed1ng l\u1ea1i kh\u00e1ng nguy\u00ean RhD (g\u1ecdi l\u00e0 kh\u00e1ng th\u1ec3 anti-D). Qu\u00e1 tr\u00ecnh n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 m\u1eabn c\u1ea3m (sensitisation) hay mi\u1ec5n d\u1ecbch d\u1ecb th\u1ec3 (alloimmunisation) (NICE 2008).<\/p>\n<p>S\u00e0ng l\u1ecdc tr\u01b0\u1edbc sinh \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh nh\u00f3m m\u00e1u v\u00e0 kh\u00e1ng th\u1ec3 n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n cho t\u1ea5t c\u1ea3 ph\u1ee5 n\u1eef mang thai trong bu\u1ed5i kh\u00e1m thai \u0111\u1ea7u ti\u00ean, b\u1ea5t k\u1ec3 k\u1ebft qu\u1ea3 s\u00e0ng l\u1ecdc tr\u01b0\u1edbc \u0111\u00f3, nh\u01b0 m\u1ed9t ph\u1ea7n t\u00edch h\u1ee3p trong ch\u0103m s\u00f3c thai k\u1ef3. T\u1ea5t c\u1ea3 ph\u1ee5 n\u1eef c\u00f3 nh\u00f3m m\u00e1u RhD \u00e2m t\u00ednh c\u1ea7n \u0111\u01b0\u1ee3c cung c\u1ea5p th\u00f4ng tin b\u1eb1ng l\u1eddi n\u00f3i v\u00e0 b\u1eb1ng v\u0103n b\u1ea3n v\u1ec1 vi\u1ec7c d\u1ef1 ph\u00f2ng b\u1eb1ng kh\u00e1ng th\u1ec3 Anti-D trong giai \u0111o\u1ea1n tr\u01b0\u1edbc v\u00e0 sau sinh, \u0111\u1ed3ng th\u1eddi c\u00f3 c\u01a1 h\u1ed9i trao \u0111\u1ed5i v\u1ec1 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u00e0y v\u1edbi n\u1eef h\u1ed9 sinh trong th\u1eddi k\u1ef3 mang thai (ASW, 2010).<\/p>\n<p>Nguy c\u01a1 m\u1eabn c\u1ea3m \u0111\u01b0\u1ee3c gi\u1ea3m b\u1edbt b\u1eb1ng c\u00e1ch ti\u00eam globulin mi\u1ec5n d\u1ecbch Anti-D cho ph\u1ee5 n\u1eef trong nh\u1eefng t\u00ecnh hu\u1ed1ng c\u00f3 kh\u1ea3 n\u0103ng x\u1ea3y ra xu\u1ea5t huy\u1ebft m\u1eb9 &#8211; thai nhi (FMH). Li\u1ec7u ph\u00e1p d\u1ef1 ph\u00f2ng Anti-D tr\u01b0\u1edbc sinh \u0111\u1ecbnh k\u1ef3 \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb nh\u01b0 m\u1ed9t l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb cho t\u1ea5t c\u1ea3 ph\u1ee5 n\u1eef mang thai c\u00f3 nh\u00f3m m\u00e1u RhD \u00e2m t\u00ednh v\u00e0 ch\u01b0a b\u1ecb m\u1eabn c\u1ea3m v\u1edbi kh\u00e1ng nguy\u00ean RhD (NICE, 2008).<\/p>\n<p>Trong giai \u0111o\u1ea1n sau sinh, globulin mi\u1ec5n d\u1ecbch Anti-D n\u00ean \u0111\u01b0\u1ee3c ti\u00eam cho m\u1ecdi ph\u1ee5 n\u1eef RhD \u00e2m t\u00ednh ch\u01b0a b\u1ecb m\u1eabn c\u1ea3m trong v\u00f2ng 72 gi\u1edd sau khi sinh con RhD d\u01b0\u01a1ng t\u00ednh (NICE, 2008). N\u1ebfu kh\u00f4ng th\u1ec3 th\u1ef1c hi\u1ec7n trong kho\u1ea3ng th\u1eddi gian n\u00e0y, v\u1eabn c\u00f3 th\u1ec3 mang l\u1ea1i m\u1ed9t ph\u1ea7n t\u00e1c d\u1ee5ng b\u1ea3o v\u1ec7 n\u1ebfu ti\u00eam trong v\u00f2ng 10 ng\u00e0y sau s\u1ef1 ki\u1ec7n g\u00e2y m\u1eabn c\u1ea3m (British Committee for Standards in Haematology, 2014). Globulin mi\u1ec5n d\u1ecbch Anti-D n\u00ean \u0111\u01b0\u1ee3c ti\u00eam b\u1eafp v\u00e0o c\u01a1 delta.<\/p>\n<h2>D\u1ef1 ph\u00f2ng c\u00e1c s\u1ef1 ki\u1ec7n c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y m\u1eabn c\u1ea3m trong thai k\u1ef3<\/h2>\n<p>Globulin mi\u1ec5n d\u1ecbch Anti-D n\u00ean \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho t\u1ea5t c\u1ea3 ph\u1ee5 n\u1eef RhD \u00e2m t\u00ednh ch\u01b0a b\u1ecb m\u1eabn c\u1ea3m sau c\u00e1c s\u1ef1 ki\u1ec7n c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y m\u1eabn c\u1ea3m trong thai k\u1ef3 sau \u0111\u00e2y:<\/p>\n<ul>\n<li>Th\u1ee7 thu\u1eadt x\u00e2m l\u1ea5n tr\u01b0\u1edbc sinh (ch\u1ecdc \u1ed1i, sinh thi\u1ebft gai nhau, l\u1ea5y m\u00e1u thai nhi, gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng ph\u00f4i)<\/li>\n<li>Xu\u1ea5t huy\u1ebft tr\u01b0\u1edbc sinh ch\u1ea3y m\u00e1u \u00e2m \u0111\u1ea1o<\/li>\n<li>Ch\u1ea5n th\u01b0\u01a1ng v\u00f9ng b\u1ee5ng<\/li>\n<li>S\u1ea3y thai \u0111\u00ecnh ch\u1ec9 thai ngh\u00e9n b\u1eb1ng thu\u1ed1c<\/li>\n<li>Th\u1ee7 thu\u1eadt xoay thai ngo\u00e0i<\/li>\n<li>Thai ch\u1ebft trong t\u1eed vong (t\u1eeb 20 tu\u1ea7n tr\u1edf l\u00ean)<\/li>\n<li>Thai ch\u1ebft l\u01b0u<\/li>\n<li>Thai ngo\u00e0i t\u1eed cung ho\u1eb7c thai tr\u1ee9ng<\/li>\n<\/ul>\n<h2>\u0110i\u1ec1u tr\u1ecb c\u00e1c s\u1ef1 ki\u1ec7n g\u00e2y m\u1eabn c\u1ea3m<\/h2>\n<p>Sau m\u1ed9t s\u1ef1 ki\u1ec7n c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y m\u1eabn c\u1ea3m, n\u00ean ch\u1ec9 \u0111\u1ecbnh ti\u00eam d\u1ef1 ph\u00f2ng Anti-D li\u1ec1u 500 IU.<\/p>\n<p>Trong 20 tu\u1ea7n thai, kh\u00f4ng c\u1ea7n l\u1ea5y m\u1eabu Kleihauer \u0111\u1ec3 \u0111o m\u1ee9c \u0111\u1ed9 xu\u1ea5t huy\u1ebft m\u1eb9 &#8211; thai nhi (FMH), v\u00ec \u1edf giai \u0111o\u1ea1n n\u00e0y ch\u01b0a c\u00f3 \u0111\u1ee7 t\u1ebf b\u00e0o t\u1ea1o m\u00e1u c\u1ee7a thai nhi trong tu\u1ea7n ho\u00e0n \u0111\u1ec3 c\u1ea7n ph\u1ea3i \u0111o l\u01b0\u1eddng, v\u00e0 li\u1ec1u 500 IU Anti-D l\u00e0 \u0111\u1ee7 \u0111\u1ec3 b\u1ea3o v\u1ec7.<\/p>\n<p>N\u1ebfu s\u1ea3n ph\u1ee5 \u0111\u1ed3ng \u00fd ti\u00eam Anti-D, thu\u1ed1c n\u00ean \u0111\u01b0\u1ee3c ti\u00eam trong v\u00f2ng 72 gi\u1edd sau s\u1ef1 ki\u1ec7n (ASW, RCOG 2002b).<\/p>\n<p>Nh\u00e3n truy xu\u1ea5t ngu\u1ed3n g\u1ed1c Anti-D c\u1ea7n \u0111\u01b0\u1ee3c g\u1eedi l\u1ea1i Ng\u00e2n h\u00e0ng m\u00e1u c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t, theo quy \u0111\u1ecbnh ph\u00e1p l\u00fd l\u00e0 trong v\u00f2ng 48 gi\u1edd, nh\u1eb1m \u0111\u1ea3m b\u1ea3o kh\u1ea3 n\u0103ng truy xu\u1ea5t \u0111\u1ea7y \u0111\u1ee7 s\u1ea3n ph\u1ea9m. Vi\u1ec7c ti\u00eam Anti-D c\u1ea7n \u0111\u01b0\u1ee3c ghi l\u1ea1i trong h\u1ed3 s\u01a1 y t\u1ebf c\u1ee7a b\u1ec7nh nh\u00e2n, bao g\u1ed3m s\u1ed1 l\u00f4 v\u00e0 trong h\u1ed3 s\u01a1 thai s\u1ea3n \u0111i\u1ec7n t\u1eed.<\/p>\n<p>T\u1ea5t c\u1ea3 ph\u1ee5 n\u1eef b\u00e1o c\u00e1o m\u1ed9t s\u1ef1 ki\u1ec7n c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y m\u1eabn c\u1ea3m khi li\u00ean h\u1ec7 v\u1edbi nh\u00e2n vi\u00ean y t\u1ebf n\u00ean \u0111\u01b0\u1ee3c chuy\u1ec3n \u0111\u1ebfn \u0110\u01a1n v\u1ecb S\u1ea3n Ph\u1ee5 Khoa \u0111\u1ec3 \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 v\u00e0 qu\u1ea3n l\u00fd ph\u00f9 h\u1ee3p.<\/p>\n<h2>H\u01b0\u1edbng d\u1eabn qu\u1ea3n l\u00fd c\u00e1c s\u1ef1 ki\u1ec7n g\u00e2y m\u1eabn c\u1ea3m ti\u1ec1m \u1ea9n<\/h2>\n<p>Li\u1ec7u ph\u00e1p d\u1ef1 ph\u00f2ng Anti-D tr\u01b0\u1edbc sinh \u0111\u1ecbnh k\u1ef3 \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb nh\u01b0 m\u1ed9t l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb cho t\u1ea5t c\u1ea3 ph\u1ee5 n\u1eef mang thai c\u00f3 nh\u00f3m m\u00e1u RhD \u00e2m t\u00ednh v\u00e0 ch\u01b0a b\u1ecb m\u1eabn c\u1ea3m v\u1edbi kh\u00e1ng nguy\u00ean RhD (NICE, 2008).<\/p>\n<p>N\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng, t\u00ecnh tr\u1ea1ng m\u1eabn c\u1ea3m x\u1ea3y ra \u1edf 10\u201315% ph\u1ee5 n\u1eef RhD \u00e2m t\u00ednh do thai k\u1ef3. Hi\u1ec7n nay, nguy c\u01a1 m\u1eabn c\u1ea3m \u1edf V\u01b0\u01a1ng qu\u1ed1c Anh v\u00e0o kho\u1ea3ng 1 tr\u00ean 21.000 ca sinh. T\u1ea1i Anh v\u00e0 x\u1ee9 Wales, m\u1ed7i n\u0103m c\u00f3 kho\u1ea3ng 500 thai nhi m\u1eafc b\u1ec7nh tan m\u00e1u (HDFN), trong \u0111\u00f3 20\u201330 tr\u01b0\u1eddng h\u1ee3p t\u1eed vong m\u1ed7i n\u0103m.<\/p>\n<p>Khi m\u1eabn c\u1ea3m \u0111\u00e3 x\u1ea3y ra, kh\u00f4ng th\u1ec3 \u0111\u1ea3o ng\u01b0\u1ee3c v\u00e0 c\u00f3 th\u1ec3 g\u00e2y \u1ea3nh h\u01b0\u1edfng nghi\u00eam tr\u1ecdng \u0111\u1ebfn thai k\u1ef3 hi\u1ec7n t\u1ea1i ho\u1eb7c c\u00e1c thai k\u1ef3 sau c\u0169ng nh\u01b0 g\u00e2y kh\u00f3 kh\u0103n khi c\u1ea7n truy\u1ec1n m\u00e1u (ASW, 2007).<\/p>\n<p>Vi\u1ec7c x\u00e1c \u0111\u1ecbnh ph\u1ee5 n\u1eef c\u00f3 nh\u00f3m m\u00e1u RhD \u00e2m t\u00ednh sau bu\u1ed5i kh\u00e1m thai c\u1ea7n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n k\u1ecbp th\u1eddi. Trong bu\u1ed5i kh\u00e1m v\u1edbi n\u1eef h\u1ed9 sinh \u1edf tu\u1ea7n th\u1ee9 16 c\u1ea7n gi\u1ea3i th\u00edch tr\u1ef1c ti\u1ebfp cho thai ph\u1ee5 v\u1ec1 \u00fd ngh\u0129a c\u1ee7a vi\u1ec7c c\u00f3 nh\u00f3m m\u00e1u Rh \u00e2m t\u00ednh, \u0111\u1ed3ng th\u1eddi cung c\u1ea5p t\u1edd th\u00f4ng tin cho b\u1ec7nh nh\u00e2n \u201cD\u1ef1 ph\u00f2ng Anti-D trong thai k\u1ef3\u201d.<\/p>\n<h2>H\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng Anti-D t\u1ea1i ph\u00f2ng kh\u00e1m<\/h2>\n<p>Sau khi x\u00e1c \u0111\u1ecbnh ph\u1ee5 n\u1eef c\u00f3 nh\u00f3m m\u00e1u Rh \u00e2m:<\/p>\n<p>Hi\u1ec7n ch\u01b0a c\u00f3 d\u1eef li\u1ec7u so s\u00e1nh tr\u1ef1c ti\u1ebfp \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 gi\u1eefa m\u1ed9t li\u1ec1u duy nh\u1ea5t (1500 IU) v\u00e0 hai li\u1ec1u nh\u1ecf h\u01a1n (500 IU) c\u1ee7a Anti-D.<\/p>\n<p>Theo NICE 2008, n\u00ean s\u1eed d\u1ee5ng ch\u1ebf ph\u1ea9m Anti-D c\u00f3 hi\u1ec7u qu\u1ea3 chi ph\u00ed cao nh\u1ea5t t\u1ea1i \u0111\u1ecba ph\u01b0\u01a1ng. Vi\u1ec7c ti\u00eam m\u1ed9t li\u1ec1u duy nh\u1ea5t \u0111\u01b0\u1ee3c xem l\u00e0 hi\u1ec7u qu\u1ea3 h\u01a1n v\u1ec1 chi ph\u00ed, tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb v\u00e0 t\u00ednh thu\u1eadn ti\u1ec7n (NICE, 2008).<\/p>\n<ul>\n<li>Cu\u1ed9c h\u1eb9n ti\u00eam Anti-D n\u00ean \u0111\u01b0\u1ee3c l\u00ean l\u1ecbch trong kho\u1ea3ng t\u1eeb 28 \u0111\u1ebfn 32 tu\u1ea7n thai.<\/li>\n<\/ul>\n<p>V\u00e0o ng\u00e0y ti\u00eam:<\/p>\n<ul>\n<li>N\u1eef h\u1ed9 sinh ph\u1ea3i \u0111\u1ea3m b\u1ea3o h\u1ed9p thu\u1ed1c \u0111i\u1ec1u tr\u1ecb s\u1ed1c ph\u1ea3n v\u1ec7 c\u00f3 s\u1eb5n trong ph\u00f2ng v\u00e0 \u0111\u01b0\u1ee3c ki\u1ec3m tra h\u00e0ng ng\u00e0y.<\/li>\n<li>Ki\u1ec3m tra thai ph\u1ee5 v\u00e0 h\u1ed3 s\u01a1 thai s\u1ea3n xem m\u1eabu m\u00e1u x\u00e9t nghi\u1ec7m nh\u00f3m m\u00e1u v\u00e0 c\u00f4ng th\u1ee9c m\u00e1u \u1edf tu\u1ea7n 28 \u0111\u00e3 \u0111\u01b0\u1ee3c l\u1ea5y ch\u01b0a.<\/li>\n<li>Sau khi \u0111\u01b0\u1ee3c gi\u1ea3i th\u00edch \u0111\u1ea7y \u0111\u1ee7 v\u00e0 c\u00f3 s\u1ef1 \u0111\u1ed3ng \u00fd c\u1ee7a thai ph\u1ee5, ti\u1ebfn h\u00e0nh ti\u00eam 1500 IU Anti-D \u0111\u01b0\u1eddng ti\u00eam b\u1eafp v\u00e0o c\u01a1 delta, \u0111\u1ed3ng th\u1eddi x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c danh t\u00ednh b\u1ec7nh nh\u00e2n tr\u01b0\u1edbc khi ti\u00eam.<\/li>\n<\/ul>\n<h2>\u0110i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng sau sinh<\/h2>\n<p>Ho\u00e0n th\u00e0nh phi\u1ebfu ng\u00e2n h\u00e0ng m\u00e1u cho m\u1eabu m\u00e1u d\u00e2y r\u1ed1n\/m\u00e1u tr\u1ebb s\u01a1 sinh, bao g\u1ed3m th\u00f4ng tin c\u1ee7a tr\u1ebb v\u00e0 s\u1ed1 h\u1ed3 s\u01a1 b\u1ec7nh \u00e1n, y\u00eau c\u1ea7u x\u00e1c \u0111\u1ecbnh nh\u00f3m m\u00e1u v\u00e0 ghi r\u00f5 r\u1eb1ng ng\u01b0\u1eddi m\u1eb9 sau sinh c\u00f3 nh\u00f3m m\u00e1u RhD \u00e2m t\u00ednh. Thu th\u1eadp 5 ml m\u00e1u d\u00e2y r\u1ed1n v\u00e0o \u1ed1ng nghi\u1ec7m n\u1eafp m\u00e0u h\u1ed3ng. M\u00e1u d\u00e2y r\u1ed1n \u0111\u01b0\u1ee3c \u01b0u ti\u00ean h\u01a1n so v\u1edbi m\u1eabu m\u00e1u l\u1ea5y sau khi sinh, v\u00ec th\u01b0\u1eddng c\u00f3 l\u01b0\u1ee3ng \u0111\u1ee7 l\u1edbn h\u01a1n, d\u1ec5 ph\u00e2n t\u00edch h\u01a1n v\u00e0 cho k\u1ebft qu\u1ea3 nhanh h\u01a1n.<\/p>\n<p>L\u1ea5y 2 m\u1eabu m\u00e1u m\u1eb9, m\u1ed7i m\u1eabu 5 ml, cho v\u00e0o hai \u1ed1ng nghi\u1ec7m n\u1eafp h\u1ed3ng. Kh\u00f4ng n\u00ean l\u1ea5y m\u00e1u m\u1eb9 s\u1edbm h\u01a1n 30\u201345 ph\u00fat sau khi s\u1ed5 thai, v\u00e0 th\u1ef1c h\u00e0nh t\u1ed1t nh\u1ea5t l\u00e0 l\u1ea5y m\u1eabu trong v\u00f2ng 2 gi\u1edd sau sinh.<\/p>\n<p>N\u1ebfu c\u00f3 th\u1ec3, g\u1eedi c\u00e1c m\u1eabu c\u00f9ng nhau trong c\u00f9ng m\u1ed9t t\u00fai \u0111\u1ec3 duy tr\u00ec t\u00ednh li\u00ean k\u1ebft.<\/p>\n<p>N\u1ebfu ng\u01b0\u1eddi m\u1eb9 c\u00f3 kh\u00e1ng th\u1ec3 (Rhesus, D, c ho\u1eb7c KELL), g\u1eedi m\u1eabu m\u00e1u d\u00e2y r\u1ed1n \u0111\u1ec3 l\u00e0m x\u00e9t nghi\u1ec7m Coombs, x\u00e1c \u0111\u1ecbnh nh\u00f3m m\u00e1u ABO &amp; Rh, Hb v\u00e0 bilirubin huy\u1ebft thanh. Th\u00f4ng b\u00e1o cho b\u00e1c s\u0129 Nhi Khoa v\u1ec1 ca sinh.<\/p>\n<p>N\u1ebfu tr\u1ebb c\u00f3 nh\u00f3m m\u00e1u RhD d\u01b0\u01a1ng t\u00ednh, 500 IU Anti-D s\u1ebd \u0111\u01b0\u1ee3c c\u1ea5p ph\u00e1t \u0111\u1ec3 ti\u00eam cho ng\u01b0\u1eddi m\u1eb9. N\u1ebfu th\u1ec3 t\u00edch xu\u1ea5t huy\u1ebft m\u1eb9 &#8211; thai nhi (FMH) &gt; 4 ml, c\u00f3 th\u1ec3 c\u1ea7n li\u1ec1u Anti-D l\u1edbn h\u01a1n.<\/p>\n<p>N\u1ebfu tr\u1ebb c\u00f3 nh\u00f3m m\u00e1u RhD \u00e2m t\u00ednh, kh\u00f4ng c\u1ea7n ti\u00eam Anti-D v\u00e0 \u0111i\u1ec1u n\u00e0y c\u1ea7n \u0111\u01b0\u1ee3c ghi r\u00f5 trong h\u1ed3 s\u01a1 c\u1ee7a m\u1eb9 v\u00e0 trong l\u1ed9 tr\u00ecnh ch\u0103m s\u00f3c sau sinh.<\/p>\n<p>L\u01b0\u1ee3t d\u1ecbch: NT HN<\/p>\n<p>T\u00c0I LI\u1ec6U THAM KH\u1ea2O<\/p>\n<p>https:\/\/wisdom.nhs.wales\/health-board-guidelines\/c-vmantenatalcarefile\/anti-d-prophylaxis-for-women-who-are-rhesus-d-rhd-negative\/<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Nh\u00f3m m\u00e1u RH \u00e2m l\u00e0 g\u00ec? T\u1ebf b\u00e0o h\u1ed3ng c\u1ea7u c\u1ee7a ng\u01b0\u1eddi mang nhi\u1ec1u lo\u1ea1i kh\u00e1ng nguy\u00ean tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a ch\u00fang. Trong s\u1ed1 \u0111\u00f3, h\u1ec7 nh\u00f3m m\u00e1u ABO v\u00e0 Rh l\u00e0 hai th\u1ee9 quan tr\u1ecdng nh\u1ea5t. Trong Rh, kh\u00e1ng nguy\u00ean D l\u00e0 kh\u00e1ng nguy\u00ean quan tr\u1ecdng nh\u1ea5t. Nh\u1eefng ng\u01b0\u1eddi c\u00f3 kh\u00e1ng nguy\u00ean Rhesus D [&#8230;]\n","protected":false},"author":1,"featured_media":146677,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-146665","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\/146665","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=146665"}],"version-history":[{"count":1,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/146665\/revisions"}],"predecessor-version":[{"id":146678,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/146665\/revisions\/146678"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/146677"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=146665"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=146665"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=146665"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}