C\u00e2u h\u1ecfi 1.<\/strong> \u0110\u1ecbnh ngh\u0129a nh\u01b0 th\u1ebf n\u00e0o l\u00e0 ti\u1ec1n s\u1ea3n gi\u1eadt<\/strong> n\u1eb7ng?<\/div>\n
Theo \u0111\u1ecbnh ngh\u0129a th\u00f4ng th\u01b0\u1eddng<\/p>\n
Ti\u1ec1n s\u1ea3n gi\u1eadt l\u00e0 nh\u1eefng thai ph\u1ee5 c\u00f3 huy\u1ebft \u00e1p t\u1ed1i \u0111a t\u1eeb 140mmHg tr\u1edf l\u00ean ho\u1eb7c\/v\u00e0 huy\u1ebft \u00e1p t\u1ed1i thi\u1ec3u t\u1eeb 90mmHg tr\u1edf l\u00ean. V\u00e0 \u0111\u1ecbnh l\u01b0\u1ee3ng protein trong n\u01b0\u1edbc ti\u1ec3u t\u1eeb 0,3g\/24 gi\u1edd (ho\u1eb7c theo th\u00f3i quen \u0111\u1ecbnh l\u01b0\u1ee3ng m\u1eabu n\u01b0\u1edbc ti\u1ec3u b\u1ea5t k\u1ef3 protein 0,5g\/l).<\/p>\n
Tr\u00ean n\u1ec1n c\u1ee7a thai ph\u1ee5 nh\u01b0 m\u00f4 t\u1ea3 \u1edf tr\u00ean, xu\u1ea5t hi\u1ec7n m\u1ed9t trong nh\u1eefng tri\u1ec7u ch\u1ee9ng sau \u0111\u00e2y, th\u00ec \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng:<\/p>\n
\n
Huy\u1ebft \u00e1p t\u0103ng n\u1eb7ng, ho\u1eb7c kh\u00f4ng ki\u1ec3m so\u00e1t: HA t\u1ed1i \u0111a \u2265 160 mmHg v\u00e0\/ho\u1eb7c HA t\u1ed1i thi\u1ec3u \u2265 110 mmHg.<\/li>\n
Protein ni\u1ec7u \u2265 3 g\/24 gi\u1edd (ho\u1eb7c 3,5 g\/l \u0111\u1ed1i v\u1edbi m\u1eabu n\u01b0\u1edbc ti\u1ec3u b\u1ea5t k\u1ef3).<\/li>\n
Creatinin m\u00e1u \u2265 90\u03bcmol\/l.<\/li>\n
Thi\u1ec3u ni\u1ec7u, l\u01b0\u1ee3ng n\u01b0\u1edbc ti\u1ec3u \u2264 500ml\/24 h ho\u1eb7c \u2264 25ml\/1h.<\/li>\n
Gi\u1ea3m ti\u1ec3u c\u1ea7u: s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u \u2264 100 000\/mm^{3<\/sup>.<\/li>\n}
Ho\u1ea1i t\u1eed t\u1ebf b\u00e0o gan: ASAT\/ALAT t\u0103ng t\u1eeb g\u1ea5p 2 l\u1ea7n tr\u1edf l\u00ean.<\/li>\n
\u0110au b\u1ee5ng v\u00f9ng th\u01b0\u1ee3ng v\u1ecb v\u00e0\/ ho\u1eb7c \u0111au v\u00f9ng h\u1ea1 s\u01b0\u1eddn ph\u1ea3i: \u0111au th\u1eaft, dai d\u1eb3ng v\u00e0 m\u1ea1nh<\/li>\n
\u0110au ng\u1ef1c, kh\u00f3 th\u1edf, ph\u00f9 ph\u1ed5i c\u1ea5p.<\/li>\n
C\u00e1c d\u1ea5u hi\u1ec7u th\u1ea7n kinh: \u0110au \u0111\u1ea7u n\u1eb7ng, kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb thu\u1ed1c gi\u1ea3m \u0111au, r\u1ed1i lo\u1ea1n th\u1ecb gi\u00e1c, th\u00ednh gi\u00e1c, dai d\u1eb3ng, ph\u1ea3n x\u1ea1 g\u00e2n x\u01b0\u01a1ng t\u0103ng m\u1ea1nh, lan to\u1ea3 v\u00e0 \u0111a \u0111\u1ed9ng.<\/li>\n<\/ul>\n
N\u1ebfu v\u01b0\u1ee3t c\u00e1c gi\u00e1 tr\u1ecb ng\u01b0\u1ee1ng c\u1ee7a nh\u1eefng ch\u1ec9 s\u1ed1 sinh h\u1ecdc \u0111\u00e3 \u0111\u01b0\u1ee3c ghi \u1edf tr\u00ean th\u00ec s\u1ef1 n\u1eb7ng l\u00ean c\u1ee7a m\u1ed9t trong nh\u1eefng ch\u1ec9 s\u1ed1 n\u00e0y c\u0169ng tr\u1edf th\u00e0nh m\u1ed9t ch\u1ec9 ti\u00eau ch\u1ea9n \u0111o\u00e1n ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng.<\/p>\n
M\u1ed9t s\u1ed1 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng hay tri\u1ec7u ch\u1ee9ng sinh h\u1ecdc bi\u1ec3u hi\u1ec7n s\u1ef1 nghi\u00eam tr\u1ecdng c\u1ee7a b\u1ec7nh:<\/p>\n
\n
Huy\u1ebft \u00e1p t\u1ed1i \u0111a \u2265 180 mmHg ho\u1eb7c\/v\u00e0 huy\u1ebft \u00e1p t\u1ed1i thi\u1ec3u \u2265 120 mmHg<\/li>\n
\u0110au b\u1ee5ng v\u00f9ng th\u01b0\u1ee3ng v\u1ecb ho\u1eb7c\/v\u00e0 \u0111au m\u1ea1n s\u01b0\u1eddn ph\u1ea3i, \u0111au th\u1eaft, m\u1ea1nh, dai d\u1eb3ng<\/li>\n
\u0110au \u0111\u1ea7u n\u1eb7ng kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c thu\u1ed1c gi\u1ea3m \u0111au th\u00f4ng th\u01b0\u1eddng.<\/li>\n
C\u00e1c r\u1ed1i lo\u1ea1n v\u1ec1 th\u1ecb gi\u00e1c, th\u00ednh gi\u00e1c dai d\u1eb3ng, suy nh\u01b0\u1ee3c th\u1ea7n kinh, r\u1ed1i lo\u1ea1n tri gi\u00e1c,<\/li>\n
Ph\u1ea3n x\u1ea1 g\u00e2n x\u01b0\u01a1ng nhanh m\u1ea1nh, lan t\u1ecfa v\u00e0 \u0111a \u0111\u1ed9ng.<\/li>\n
Suy h\u00f4 h\u1ea5p, ph\u00f9 ph\u1ed5i c\u1ea5p.<\/li>\n
HC HELLP.<\/li>\n
Suy th\u1eadn c\u1ea5p.<\/li>\n<\/ul>\n
C\u00e2u h\u1ecfi 2.<\/strong> S\u1eed d\u1ee5ng c\u00e1c ch\u1ec9 s\u1ed1 ti\u00ean \u0111o\u00e1n bi\u1ebfn ch\u1ee9ng c\u1ee7a ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng c\u00f3 cho ph\u00e9p l\u00e0m gi\u1ea3m t\u1eed vong v\u00e0 b\u1ec7nh t\u1eadt cho m\u1eb9 v\u00e0 tr\u1ebb s\u01a1 sinh?<\/p>\n
Kh\u00f4ng c\u00f3 c\u00e1c ch\u1ee9ng c\u1edb c\u0169ng nh\u01b0 nh\u1eefng d\u1eef li\u1ec7u ch\u1ee9ng minh kh\u1ea3 n\u0103ng l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 t\u1eed vong, t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt c\u1ee7a m\u1eb9 c\u0169ng nh\u01b0 c\u1ee7a thai\/tr\u1ebb s\u01a1 sinh b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng c\u00e1c ch\u1ec9 s\u1ed1 ti\u00ean \u0111o\u00e1n m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a ti\u1ec1n s\u1ea3n gi\u1eadt v\u00e0 kh\u00f4ng th\u1ec3 \u0111\u01b0a ra nh\u1eefng khuy\u1ebfn c\u00e1o v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c ch\u1ec9 s\u1ed1 ti\u00ean \u0111o\u00e1n trong th\u1ef1c h\u00e0nh \u0111\u1ec3 theo d\u00f5i v\u00e0 x\u1eed tr\u00ed ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng.<\/p>\n
Th\u00e1i \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb<\/h2>\n
C\u00e2u h\u1ecfi 1:<\/strong> Ng\u01b0\u1ee1ng huy\u1ebft \u00e1p n\u00e0o, c\u1ea7n ph\u1ea3i can thi\u1ec7p \u0111i\u1ec1u tr\u1ecb v\u00e0 \u0111i\u1ec1u tr\u1ecb thu\u1ed1c b\u1eb1ng \u0111\u01b0\u1eddng n\u00e0o \u0111\u1ec3 l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 t\u1eed vong, t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt ng\u01b0\u1eddi m\u1eb9 ho\u1eb7c\/v\u00e0 tr\u1ebb s\u01a1 sinh?<\/p>\n
Khuy\u1ebfn c\u00e1o \u0111i\u1ec1u tr\u1ecb m\u1ed9t c\u00e1ch h\u1ec7 th\u1ed1ng b\u1eb1ng c\u00e1c thu\u1ed1c h\u1ea1 \u00e1p \u1edf thai ph\u1ee5 c\u00f3 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng khi m\u00e0 huy\u1ebft \u00e1p t\u1ed1i \u0111a \u2265 160 mmHg ho\u1eb7c\/v\u00e0 huy\u1ebft \u00e1p t\u1ed1i thi\u1ec3u \u2265 110 mmHg khi ngh\u1ec9 ng\u01a1i v\u00e0 dai d\u1eb3ng h\u01a1n 15 ph\u00fat \u2192 M\u1ee5c ti\u00eau: gi\u1eef \u0111\u01b0\u1ee3c ng\u01b0\u1ee1ng huy\u1ebft \u00e1p d\u01b0\u1edbi nh\u1eefng tr\u1ecb s\u1ed1 n\u00e0y \u2192 gi\u1ea3m bi\u1ebfn ch\u1ee9ng n\u1eb7ng cho m\u1eb9, thai v\u00e0 tr\u1ebb s\u01a1 sinh.<\/p>\n
Trong tr\u01b0\u1eddng h\u1ee3p ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, k\u00e8m theo xu\u1ea5t hi\u1ec7n m\u1ed9t trong nh\u1eefng d\u1ea5u hi\u1ec7u t\u0103ng n\u1eb7ng v\u1ec1 l\u00e2m s\u00e0ng c\u0169ng nh\u01b0 v\u1ec1 sinh h\u1ecdc, ho\u1eb7c huy\u1ebft \u00e1p t\u0103ng n\u1eb7ng dai d\u1eb3ng m\u1eb7c d\u00f9 \u0111ang \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb thu\u1ed1c h\u1ea1 \u00e1p \u0111\u01b0\u1eddng u\u1ed1ng, 1 thu\u1ed1c ho\u1eb7c 2 thu\u1ed1c \u2192 Khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng thu\u1ed1c h\u1ea1 \u00e1p \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch.<\/p>\n
C\u00e2u h\u1ecfi 2.<\/strong> \u1ede ng\u01b0\u1eddi ph\u1ee5 n\u1eef ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, lo\u1ea1i thu\u1ed1c h\u1ea1 \u00e1p n\u00e0o \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb cho ph\u00e9p l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt c\u1ee7a m\u1eb9 v\u00e0 tr\u1ebb s\u01a1 sinh?<\/p>\n
Khi thu\u1ed1c h\u1ea1 \u00e1p \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh d\u00f9ng: Labetalol l\u00e0 l\u1ef1a ch\u1ecdn h\u00e0ng \u0111\u1ea7u \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng cho thai ph\u1ee5 b\u1ecb ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng.<\/p>\n
Khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng Nicardipin, ho\u1eb7c Urapidil ph\u1ed1i h\u1ee3p v\u1edbi Labetalol truy\u1ec1n t\u0129nh m\u1ea1ch, trong tr\u01b0\u1eddng h\u1ee3p huy\u1ebft \u00e1p cao kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c, ho\u1eb7c d\u00f9ng \u0111\u1ec3 thay th\u1ebf Labetalol t\u0129nh m\u1ea1ch, trong tr\u01b0\u1eddng h\u1ee3p c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh s\u1eed d\u1ee5ng thu\u1ed1c ch\u1eb9n beta (\u03b2 bloquant).<\/p>\n
Trong tr\u01b0\u1eddng h\u1ee3p ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng m\u00e0 huy\u1ebft \u00e1p ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c b\u1eb1ng c\u00e1c thu\u1ed1c h\u1ea1 \u00e1p \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch \u2192 khuy\u1ebfn c\u00e1o ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb nh\u01b0 v\u1eady, v\u00e0 xen k\u1ebd ti\u1ebfp m\u1ed9t \u0111\u1ee3t \u0111i\u1ec1u tr\u1ecb thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p \u0111\u01b0\u1eddng u\u1ed1ng \u2192 \u0111\u1ec3 l\u00e0m gi\u1ea3m nguy c\u01a1 t\u00e1i ph\u00e1t t\u0103ng huy\u1ebft \u00e1p n\u1eb7ng, v\u00e0 c\u00e1c h\u1eadu qu\u1ea3 cho m\u1eb9, thai v\u00e0 tr\u1ebb s\u01a1 sinh.<\/p>\n
Trong tr\u01b0\u1eddng h\u1ee3p ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, huy\u1ebft \u00e1p ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c b\u1eb1ng c\u00e1c thu\u1ed1c h\u1ea1 \u00e1p \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch (huy\u1ebft \u00e1p t\u1ed1i \u0111a <160 mmHg, huy\u1ebft \u00e1p t\u1ed1i thi\u1ec3u <110 mmHg). Khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p \u0111\u01b0\u1eddng u\u1ed1ng, v\u00e0 thu\u1ed1c \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn \u0111\u00f3 l\u00e0 Labetalol.<\/p>\n
C\u00e1c chuy\u00ean gia g\u1ee3i \u00fd s\u1eed d\u1ee5ng, Nicardipin hay alpha- methyldopa ph\u1ed1i h\u1ee3p v\u1edbi Labetalol \u0111\u01b0\u1eddng u\u1ed1ng, n\u1ebfu huy\u1ebft \u00e1p kh\u00f4ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c, ho\u1eb7c thay th\u1ebf Labetalol trong tr\u01b0\u1eddng h\u1ee3p ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh s\u1eed d\u1ee5ng thu\u1ed1c ch\u1eb9n beta (\u03b2 bloquant).<\/p>\n
C\u00e2u h\u1ecfi 3.<\/strong> \u1ede ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u00f3 thai b\u1ecb ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, s\u1eed d\u1ee5ng sulfat magie tr\u01b0\u1edbc khi sinh c\u00f3 l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt cho b\u00e0 m\u1eb9 ho\u1eb7c\/v\u00e0 tr\u1ebb s\u01a1 sinh kh\u00f4ng?<\/p>\n
Khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng sulphat magie tr\u01b0\u1edbc khi sinh cho nh\u1eefng tr\u01b0\u1eddng h\u1ee3p ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, c\u00f3 \u00edt nh\u1ea5t m\u1ed9t d\u1ea5u hi\u1ec7u t\u0103ng n\u1eb7ng \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 x\u1ea3y ra s\u1ea3n gi\u1eadt<\/p>\n
Khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng sulphat magie tr\u01b0\u1edbc khi sinh \u1edf nh\u1eefng thai ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng m\u00e0 c\u00f3 xu\u1ea5t hi\u1ec7n \u00edt nh\u1ea5t m\u1ed9t d\u1ea5u hi\u1ec7u t\u0103ng n\u1eb7ng \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 xu\u1ea5t hi\u1ec7n rau bong non.<\/p>\n
C\u00e2u h\u1ecfi 4:<\/strong> Trong tr\u01b0\u1eddng h\u1ee3p thai ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, vi\u1ec7c b\u1ed3i ph\u1ee5 d\u1ecbch m\u1ed9t c\u00e1ch h\u1ec7 th\u1ed1ng v\u00e0o tu\u1ea7n ho\u00e0n ng\u01b0\u1eddi m\u1eb9 c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m nguy c\u01a1 b\u1ec7nh t\u1eadt cho ng\u01b0\u1eddi m\u1eb9 v\u00e0 ho\u1eb7c tr\u1ebb s\u01a1 sinh kh\u00f4ng?<\/p>\n
Kh\u00f4ng khuy\u1ebfn c\u00e1o b\u1ed3i ph\u1ee5 d\u1ecbch m\u1ed9t c\u00e1ch h\u1ec7 th\u1ed1ng v\u00e0o tu\u1ea7n ho\u00e0n c\u1ee7a ng\u01b0\u1eddi m\u1eb9 b\u1ecb ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng \u0111\u1ec3 l\u00e0m gi\u1ea3m nguy c\u01a1 b\u1ec7nh t\u1eadt cho ng\u01b0\u1eddi m\u1eb9 v\u00e0 ho\u1eb7c tr\u1ebb s\u01a1 sinh.<\/p>\n
C\u00e2u h\u1ecfi 5:<\/strong>\u00a0\u1ede nh\u1eefng thai ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, s\u1eed d\u1ee5ng corticoid c\u00f3 l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt cho ng\u01b0\u1eddi m\u1eb9?<\/p>\n
Trong tr\u01b0\u1eddng h\u1ee3p ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u00f3 thai b\u1ecb ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, ngay c\u1ea3 \u0111\u1ed1i v\u1edbi nh\u1eefng tr\u01b0\u1eddng h\u1ee3p h\u1ed9i ch\u1ee9ng HELLP, kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng glucocorticoide \u0111\u1ec3 l\u00e0m gi\u1ea3m b\u1ec7nh t\u1eadt cho ng\u01b0\u1eddi m\u1eb9.<\/p>\n
C\u00e2u h\u1ecfi 6:<\/strong> \u1ede nh\u1eefng thai ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng c\u00f3 m\u1ed9t c\u01a1n s\u1ea3n gi\u1eadt, s\u1eed d\u1ee5ng Sulfat Magie so v\u1edbi s\u1eed d\u1ee5ng benzodiazepam c\u00f3 cho ph\u00e9p l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt \u1edf ng\u01b0\u1eddi m\u1eb9 c\u0169ng nh\u01b0 l\u00e0m gi\u1ea3m c\u01a1n gi\u1eadt t\u00e1i ph\u00e1t kh\u00f4ng?<\/p>\n
Khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng Sulfat Magie l\u00e0 l\u1ef1a ch\u1ecdn h\u00e0ng \u0111\u1ea7u cho nh\u1eefng thai ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng c\u00f3 c\u01a1n s\u1ea3n gi\u1eadt \u2192 \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 t\u1eed vong m\u1eb9 v\u00e0 nguy c\u01a1 t\u00e1i ph\u00e1t c\u01a1n s\u1ea3n gi\u1eadt.<\/p>\n
Theo d\u00f5i v\u00e0 \u0111\u00e1nh gi\u00e1<\/h2>\n
C\u00e2u h\u1ecfi 1:<\/strong> Trong tr\u01b0\u1eddng h\u1ee3p thai ph\u1ee5 b\u1ecb ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, s\u1eed d\u1ee5ng si\u00eau \u00e2m l\u1ed3ng ng\u1ef1c ng\u01b0\u1eddi m\u1eb9 (tim v\u00e0 ph\u1ed5i) v\u1edbi m\u1ee5c \u0111\u00edch h\u01b0\u1edbng d\u1eabn \u0111\u1ec3 b\u1ed3i ph\u1ee5 tu\u1ea7n ho\u00e0n cho ng\u01b0\u1eddi m\u1eb9 c\u00f3 cho ph\u00e9p l\u00e0m gi\u1ea3m nguy b\u1ec7nh t\u1eadt cho ng\u01b0\u1eddi m\u1eb9 (do l\u00e0m gi\u1ea3m nguy c\u01a1 ph\u00f9 ph\u1ed5i c\u1ea5p) v\u00e0 ho\u1eb7c tr\u1ebb s\u01a1 sinh?<\/p>\n
Thi\u1ebfu nh\u1eefng d\u1eef li\u1ec7u v\u1ec1 vi\u1ec7c b\u1ed3i ph\u1ee5 tu\u1ea7n ho\u00e0n cho ng\u01b0\u1eddi m\u1eb9 d\u01b0\u1edbi h\u01b0\u1edbng d\u1eabn c\u1ee7a si\u00eau \u00e2m l\u1ed3ng ng\u1ef1c ng\u01b0\u1eddi m\u1eb9 (tim v\u00e0 ph\u1ed5i) \u1edf nh\u1eefng thai ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng v\u00e0 t\u00e1c \u0111\u1ed9ng c\u1ee7a vi\u1ec7c n\u00e0y \u0111\u1ebfn t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt ng\u01b0\u1eddi m\u1eb9 v\u00e0 ho\u1eb7c tr\u1ebb s\u01a1 sinh \u2192 Kh\u00f4ng th\u1ec3 \u0111\u01b0a ra khuy\u1ebfn c\u00e1o v\u1ec1 v\u1ea5n \u0111\u1ec1 n\u00e0y.<\/p>\n
C\u00e2u h\u1ecfi 2:<\/strong> \u1ede nh\u1eefng thai ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, c\u00f3 k\u00e8m theo xu\u1ea5t hi\u1ec7n \u00edt nh\u1ea5t m\u1ed9t d\u1ea5u hi\u1ec7u t\u0103ng n\u1eb7ng th\u00ec vi\u1ec7c theo ph\u1ee5 n\u00e0y \u1edf m\u1ed9t \u0111\u01a1n v\u1ecb ri\u00eang c\u00f3 l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt \u1edf ng\u01b0\u1eddi m\u1eb9 v\u00e0 ho\u1eb7c tr\u1ebb s\u01a1 sinh kh\u00f4ng?<\/p>\n
Trong tr\u01b0\u1eddng h\u1ee3p ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, xu\u1ea5t hi\u1ec7n \u00edt nh\u1ea5t m\u1ed9t d\u1ea5u hi\u1ec7u t\u0103ng n\u1eb7ng, c\u00e1c chuy\u00ean gia g\u1ee3i \u00fd c\u1ea7n c\u00f3 m\u1ed9t \u0111\u01a1n v\u1ecb \u0111a l\u0129nh v\u1ef1c cho ph\u00e9p theo d\u00f5i li\u00ean t\u1ee5c ng\u01b0\u1eddi m\u1eb9, v\u1edbi m\u1ee5c \u0111\u00edch l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt cho m\u1eb9 v\u00e0 tr\u1ebb s\u01a1 sinh. X\u00e1c \u0111\u1ecbnh n\u01a1i theo d\u00f5i c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c quy\u1ebft \u0111\u1ecbnh t\u1ea1i ch\u1ed7 t\u00f9y thu\u1ed9c v\u00e0o vi\u1ec7c t\u1ed5 ch\u1ee9c ch\u0103m s\u00f3c.<\/p>\n
C\u00e1c ti\u00eau chu\u1ea9n ng\u1eebng thai ngh\u00e9n<\/h2>\n
C\u00e2u h\u1ecfi 1:<\/strong> \u1ede nh\u1eefng thai ph\u1ee5 c\u00f3 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, tu\u1ed5i thai t\u1eeb 24-34 tu\u1ea7n, vi\u1ec7c ti\u1ebfp t\u1ee5c theo d\u00f5i thai c\u00f3 cho ph\u00e9p l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt \u1edf tr\u1ebb s\u01a1 sinh v\u00e0 kh\u00f4ng l\u00e0m t\u0103ng t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt cho ng\u01b0\u1eddi m\u1eb9 so v\u1edbi vi\u1ec7c ng\u1eebng thai ngh\u00e9n sau 48h sau khi s\u1eed d\u1ee5ng corticoide kh\u00f4ng?<\/p>\n
Trong tr\u01b0\u1eddng h\u1ee3p ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, tu\u1ed5i thai 24-34 tu\u1ea7n: khuy\u1ebfn c\u00e1o theo d\u00f5i thai ngh\u00e9n \u0111\u1ebfn 34 tu\u1ea7n (n\u1ebfu kh\u00f4ng c\u00f3 xu\u1ea5t hi\u1ec7n \u00edt nh\u1ea5t m\u1ed9t d\u1ea5u hi\u1ec7u t\u0103ng n\u1eb7ng \u1edf ng\u01b0\u1eddi m\u1eb9 ho\u1eb7c \u1edf thai) \u0111\u1ec3 l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt cho tr\u1ebb s\u01a1 sinh v\u00e0 kh\u00f4ng l\u00e0m t\u0103ng t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt cho ng\u01b0\u1eddi m\u1eb9.<\/p>\n
C\u00e2u h\u1ecfi 2:<\/strong> \u1ede nh\u1eefng thai ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, m\u1ed5 l\u1ea5y thai so s\u00e1nh v\u1edbi vi\u1ec7c th\u1eed cho \u0111\u1ebb \u0111\u01b0\u1eddng d\u01b0\u1edbi c\u00f3 cho ph\u00e9p l\u00e0m gi\u1ea3m b\u1ec7nh t\u1eadt cho ng\u01b0\u1eddi m\u1eb9 v\u00e0 ho\u1eb7c tr\u1ebb s\u01a1 sinh kh\u00f4ng?<\/p>\n
Khuy\u1ebfn c\u00e1o cho th\u1ea5y r\u1eb1ng kh\u00f4ng c\u00f3 nh\u1eefng l\u1ee3i \u00edch k\u00e8m theo khi th\u1ef1c hi\u1ec7n m\u1ed5 l\u1ea5y thai theo ch\u01b0\u01a1ng tr\u00ecnh. C\u00e1c chuy\u00ean gia g\u1ee3i \u00fd kh\u00f4ng n\u00ean th\u1ef1c hi\u1ec7n m\u1ed5 l\u1ea5y thai m\u1ed9t c\u00e1ch h\u1ec7 th\u1ed1ng trong tr\u01b0\u1eddng h\u1ee3p ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng.<\/p>\n
C\u00e2u h\u1ecfi 3:<\/strong> \u1ede nh\u1eefng thai ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng c\u00f3 xu\u1ea5t hi\u1ec7n c\u01a1n s\u1ea3n gi\u1eadt th\u00ec trong th\u1eddi h\u1ea1n bao l\u00e2u th\u00ec c\u1ea7n ph\u1ea3i l\u1ea5y thai \u0111\u1ec3 gi\u1ea3m t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt cho m\u1eb9 v\u00e0 thai?<\/p>\n
Sau c\u01a1n s\u1ea3n gi\u1eadt, c\u00e1c chuy\u00ean gia g\u1ee3i \u00fd n\u1ebfu kh\u00f4ng c\u00f3 c\u1ea5p c\u1ee9u v\u1ec1 s\u1ef1 sinh t\u1ed3n c\u1ee7a ng\u01b0\u1eddi m\u1eb9 c\u0169ng nh\u01b0 c\u1ee7a thai, t\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng ng\u01b0\u1eddi m\u1eb9 \u1ed5n \u0111\u1ecbnh \u2192 b\u1eaft \u0111\u1ea7u s\u1eed d\u1ee5ng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Sulfat Magie tr\u01b0\u1edbc khi quy\u1ebft \u0111\u1ecbnh cho sinh.<\/p>\n
G\u00e2y m\u00ea<\/h2>\n
C\u00e2u h\u1ecfi 1:<\/strong> Nh\u1eefng thai ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng n\u1ebfu c\u1ea7n thi\u1ebft ph\u1ea3i m\u1ed5 l\u1ea5y thai th\u00ec s\u1eed d\u1ee5ng g\u00e2y t\u00ea ngo\u00e0i m\u00e0ng c\u1ee9ng so v\u1edbi g\u00e2y m\u00ea to\u00e0n th\u00e2n c\u00f3 cho ph\u00e9p l\u00e0m gi\u1ea3m b\u1ec7nh t\u1eadt cho m\u1eb9 ho\u1eb7c v\u00e0 tr\u1ebb s\u01a1 sinh kh\u00f4ng? Khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng g\u00e2y t\u00ea ngo\u00e0i m\u00e0ng c\u1ee9ng h\u01a1n l\u00e0 g\u00e2y m\u00ea to\u00e0n th\u00e2n trong tr\u01b0\u1eddng h\u1ee3p m\u1ed5 l\u1ea5y thai \u1edf nh\u1eefng thai ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng \u0111\u1ec3 l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt cho ng\u01b0\u1eddi m\u1eb9.<\/p>\n
C\u00e2u h\u1ecfi 2:<\/strong> Trong s\u1ed1 nh\u1eefng thai ph\u1ee5 b\u1ecb ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng m\u00e0 c\u1ea7n ph\u1ea3i th\u1ef1c hi\u1ec7n g\u00e2y m\u00ea to\u00e0n th\u00e2n, c\u1ea7n s\u1eed d\u1ee5ng bolus thu\u1ed1c mocphin ho\u1eb7c c\u00e1c thu\u1ed1c h\u1ea1 \u00e1p c\u00f3 cho ph\u00e9p l\u00e0m gi\u1ea3m b\u1ec7nh t\u1eadt cho ng\u01b0\u1eddi m\u1eb9 v\u00e0 tr\u1ebb s\u01a1 sinh?<\/p>\n
\u00a0<\/em><\/strong>Trong tr\u01b0\u1eddng h\u1ee3p c\u1ea7n ph\u1ea3i g\u00e2y m\u00ea to\u00e0n th\u00e2n \u1edf nh\u1eefng thai ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, khuy\u1ebfn c\u00e1o trong l\u00fac kh\u1edfi m\u00ea s\u1eed d\u1ee5ng ti\u00eam mocphin, ho\u1eb7c thu\u1ed1c h\u1ea1 \u00e1p, nh\u1eb1m h\u1ea1n ch\u1ebf h\u1eadu qu\u1ea3 v\u1ec1 huy\u1ebft \u0111\u1ed9ng c\u1ee7a ng\u01b0\u1eddi m\u1eb9 do \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n.<\/p>\n
Khuy\u1ebfn c\u00e1o l\u1ef1a ch\u1ecdn h\u00e0ng \u0111\u1ea7u s\u1eed d\u1ee5ng bolus 0,5\u00b5g\/kg remifentanil trong ch\u1ec9 \u0111\u1ecbnh n\u00e0y. Alfentanil v\u00e0 esmolol \u0111\u1ec3 s\u1eed d\u1ee5ng \u0111i\u1ec1u tr\u1ecb xen k\u1ebd.<\/p>\n
Th\u00e1i \u0111\u1ed9 x\u1eed tr\u00ed sau \u0111\u1ebb<\/h2>\n
C\u00e2u h\u1ecfi 1:<\/strong> \u0110\u1ed1i v\u1edbi thai ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, s\u1eed d\u1ee5ng Sulfat Magie sau \u0111\u1ebb s\u1ebd l\u00e0m gi\u1ea3m b\u1ec7nh t\u1eadt c\u1ee7a ng\u01b0\u1eddi m\u1eb9?<\/p>\n
Khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Sulfat Magie, trong tr\u01b0\u1eddng h\u1ee3p x\u1ea3y ra s\u1ea3n gi\u1eadt sau khi \u0111\u1ebb \u0111\u1ec3 l\u00e0m gi\u1ea3m nguy c\u01a1 t\u00e1i ph\u00e1t c\u01a1n s\u1ea3n gi\u1eadt.<\/p>\n
Ch\u1eafc ch\u1eafn kh\u00f4ng khuy\u1ebfn c\u00e1o b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Sulfat Magie trong th\u1eddi k\u1ef3 h\u1eadu s\u1ea3n \u1edf s\u1ea3n ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng m\u00e0 kh\u00f4ng c\u00f3 s\u1ea3n gi\u1eadt \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 t\u1eed vong m\u1eb9 c\u0169ng nh\u01b0 xu\u1ea5t hi\u1ec7n s\u1ea3n gi\u1eadt.<\/p>\n
C\u00e2u h\u1ecfi 2: <\/strong>Trong s\u1ed1 nh\u1eefng s\u1ea3n ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u0103ng, c\u00f3 n\u00ean s\u1eed d\u1ee5ng thu\u1ed1c l\u1ee3i ti\u1ec3u trong th\u1eddi k\u1ef3 h\u1eadu s\u1ea3n \u0111\u1ec3 l\u00e0m gi\u1ea3m b\u1ec7nh t\u1eadt cho ng\u01b0\u1eddi m\u1eb9?<\/p>\n
Ch\u1eafc ch\u1eafn kh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng m\u1ed9t c\u00e1ch h\u1ec7 th\u1ed1ng thu\u1ed1c l\u1ee3i ti\u1ec3u cho s\u1ea3n ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng trong th\u1eddi k\u1ef3 h\u1eadu s\u1ea3n \u0111\u1ec3 gi\u1ea3m b\u1ec7nh t\u1eadt cho b\u00e0 m\u1eb9.<\/p>\n
C\u00e2u h\u1ecfi 3:<\/strong> \u1ede nh\u1eefng thai ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, ph\u01b0\u01a1ng \u00e1n n\u00e0o \u0111\u01b0\u1ee3c d\u00f9ng trong th\u1eddi k\u1ef3 h\u1eadu s\u1ea3n \u0111\u1ec3 d\u1ef1 ph\u00f2ng t\u1eafc m\u1ea1ch huy\u1ebft kh\u1ed1i?<\/p>\n
C\u00e1c chuy\u00ean gia khuy\u1ebfn c\u00e1o, ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng t\u1eafc m\u1ea1ch huy\u1ebft kh\u1ed1i trong th\u1eddi k\u1ef3 h\u1eadu s\u1ea3n ph\u1ea3i d\u1ef1a tr\u00ean t\u00ednh to\u00e1n nguy c\u01a1 bi\u1ebfn ch\u1ee9ng huy\u1ebft kh\u1ed1i t\u1eafc m\u1ea1ch, nh\u01b0 \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t b\u1edfi CNGOF 2015 trong khuy\u1ebfn c\u00e1o c\u1ee7a h\u1ecd.<\/p>\n
C\u00e2u h\u1ecfi 4:<\/strong> \u1ede nh\u1eefng thai ph\u1ee5 c\u00f3 c\u01a1n s\u1ea3n gi\u1eadt, s\u1eed d\u1ee5ng ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng \u00a0<\/em><\/strong>t\u1eeb n\u00e3o c\u1ee7a thai ph\u1ee5 m\u1ed9t c\u00e1ch h\u1ec7 th\u1ed1ng c\u00f3 cho ph\u00e9p gi\u1ea3m t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt c\u1ee7a ng\u01b0\u1eddi m\u1eb9?<\/p>\n
C\u1ea7n ph\u1ea3i ph\u00e2n bi\u1ec7t c\u00e1c t\u1ed5n th\u01b0\u01a1ng c\u1ee7a n\u00e3o khi c\u00f3 s\u1ea3n gi\u1eadt n\u00ean c\u00e1c chuy\u00ean gia khuy\u00ean s\u1eed d\u1ee5ng ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb c\u1ee7a n\u00e3o \u1edf nh\u1eefng thai ph\u1ee5 c\u00f3 s\u1ea3n gi\u1eadt nh\u1eb1m gi\u1ea3m c\u00e1c bi\u1ebfn ch\u1ee9ng th\u1ea7n kinh c\u1ee7a s\u1ea3n gi\u1eadt.<\/p>\n
\u0110\u00e0o t\u1ea1o c\u00e1c nh\u00f3m<\/h2>\n
C\u00e2u h\u1ecfi 1: Ph\u01b0\u01a1ng ph\u00e1p \u0111\u00f3ng vai ho\u1eb7c n\u00e2ng cao nh\u1eadn th\u1ee9c c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m t\u1ef7 l\u1ec7 b\u1ec7nh t\u1eadt cho ng\u01b0\u1eddi m\u1eb9 v\u00e0 tr\u1ebb s\u01a1 sinh trong tr\u01b0\u1eddng h\u1ee3p ch\u0103m s\u00f3c thai ph\u1ee5 ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng?<\/p>\n
V\u1ea5n \u0111\u1ec1 n\u00e0y ch\u01b0a c\u00f3 \u0111\u1ee7 d\u1eef li\u1ec7u \u0111\u1ec3 khuy\u1ebfn c\u00e1o.<\/p>\n
$\"L\u01b0\u1ee3c$
L\u01b0\u1ee3c \u0111\u1ed3 thu\u1ed1c \u0111i\u1ec1u tr\u1ecb cao huy\u1ebft \u00e1p trong ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng<\/figcaption><\/figure>\n
Th\u1ea5t b\u1ea1i = HA t\u1ed1i \u0111a \u2265 180mmHg ho\u1eb7c\/v\u00e0 HA t\u1ed1i thi\u1ec3u \u2265 120mmHg k\u00e9o d\u00e0i tr\u00ean 10 ph\u00fat.<\/p>\n
Khi HA t\u1ed1i \u0111a \u2264180mmHg, HA t\u1ed1i thi\u1ec3u \u2264 120 mmHg, ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c 10 ph\u00fat, ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tri thu\u1ed1c h\u1ea1 \u00e1p b\u1eb1ng b\u01a1m ti\u00eam \u0111i\u1ec7n li\u1ec1u t\u1ed1i thi\u1ec3u \u0111\u1ec3 \u0111\u1ea1t hi\u1ec7u qu\u1ea3 HA t\u1ed1i \u0111a \u2264 160 mmHg, HA t\u1ed1i thi\u1ec3u \u2264110 mmHg<\/p>\n
$\"L\u01b0\u1ee3c$
L\u01b0\u1ee3c \u0111\u1ed3 th\u00e1i \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb cao huy\u1ebft \u00e1p trong ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng<\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"
PGS. TS. TR\u1ea6N DANH C\u01af\u1edcNG B\u1ec7nh vi\u1ec7n Ph\u1ee5 S\u1ea3n Trung \u01af\u01a1ng www.vnras.com\/drug. \u0110\u1ec3 t\u1ea3i file PDF Khuy\u1ebfn c\u00e1o th\u00e1i \u0111\u1ed9 x\u1eed tr\u00ed ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng, h\u00e3y click T\u1ea1i \u0110\u00e2y. \u0110\u1eb6T V\u1ea4N \u0110\u1ec0 Ti\u1ec1n s\u1ea3n gi\u1eadt l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd \u0111\u1eb7c bi\u1ec7t c\u1ee7a s\u1ea3n khoa, t\u1ef7 l\u1ec7: 1- 2% s\u1ed1 ph\u1ee5 n\u1eef c\u00f3 thai. \u0110\u1eb7c […]\n","protected":false},"author":1,"featured_media":34059,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-34056","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\/34056","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=34056"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/34056\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/34059"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=34056"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=34056"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=34056"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}