{"id":5000,"date":"2019-03-18T18:11:32","date_gmt":"2019-03-18T11:11:32","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=5000"},"modified":"2019-03-18T18:11:32","modified_gmt":"2019-03-18T11:11:32","slug":"tiem-chung-trong-thoi-ki-mang-thai","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/tiem-chung-trong-thoi-ki-mang-thai\/","title":{"rendered":"Ti\u00eam ch\u1ee7ng trong th\u1eddi k\u00ec mang thai"},"content":{"rendered":"<p><strong>Ti\u00eam ch\u1ee7ng trong th\u1eddi k\u00ec mang thai<\/strong> l\u00e0 m\u1ed9t bi\u1ec7n ph\u00e1p quan tr\u1ecdng gi\u00fap b\u1ea3o v\u1ec7 \u0111\u1ee9a tr\u1ebb kh\u1ecfi c\u00e1c t\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng \u0111e do\u1ea1 t\u00ednh m\u1ea1ng trong 1 th\u00e1ng \u0111\u1ea7u \u0111\u1eddi. Vi\u1ec7c l\u00e0m n\u00e0y gi\u00fap t\u0103ng c\u01b0\u1eddng s\u1ef1 v\u1eadn chuy\u1ec3n c\u00e1c kh\u00e1ng th\u1ec3 \u0111\u1eb7c hi\u1ec7u v\u1edbi vaccine t\u1eeb m\u1eb9 qua nhau thai, \u0111em l\u1ea1i kh\u1ea3 n\u0103ng b\u1ea3o v\u1ec7 \u0111\u1ee9a tr\u1ebb kh\u1ecfi c\u00e1c b\u1ec7nh d\u1ef1 ph\u00f2ng \u0111\u01b0\u1ee3c b\u1eb1ng vaccine cho t\u1edbi khi kh\u00f4ng c\u00f2n \u1edf nh\u00f3m nguy c\u01a1 cao b\u1ecb nhi\u1ec5m tr\u00f9ng ho\u1eb7c c\u00f3 kh\u1ea3 n\u0103ng t\u1ef1 b\u1ea3o v\u1ec7 c\u01a1 th\u1ec3 b\u1eb1ng h\u1ec7 mi\u1ec5n d\u1ecbch ch\u1ee7 \u0111\u1ed9ng. U\u1ef7 ban t\u01b0 v\u1ea5n th\u1ef1c h\u00e0nh ti\u00eam ch\u1ee7ng c\u1ee7a Trung t\u00e2m Ki\u1ec3m so\u00e1t v\u00e0 Ph\u00f2ng ng\u1eeba b\u1ec7nh t\u1eadt Hoa K\u00ec v\u00e0 H\u1ed9i S\u1ea3n ph\u1ee5 khoa Hoa K\u00ec khuy\u1ebfn c\u00e1o ti\u00eam ch\u1ee7ng vaccine ho g\u00e0 v\u00e0 c\u00fam cho ph\u1ee5 n\u1eef c\u00f3 thai. Vaccine u\u1ed1n v\u00e1n, b\u1ea1ch h\u1ea7u v\u00e0 ho g\u00e0 v\u00f4 b\u00e0o (BH-HG-UV) \u0111\u01b0\u1ee3c ti\u00eam th\u01b0\u1eddng qui cho ph\u1ee5 n\u1eef c\u00f3 thai t\u1eeb tu\u1ea7n 27 \u0111\u1ebfn 36, gi\u00fap tr\u1ebb c\u00f3 kh\u00e1ng th\u1ec3 \u0111\u1eb7c hi\u1ec7u ch\u1ed1ng ho g\u00e0 trong giai do\u1ea1n c\u1eeda s\u1ed5 c\u1ee7a th\u1eddi th\u01a1 \u1ea5u khi kh\u1ea3 n\u0103ng b\u1ecb b\u1ec7nh ho g\u00e0 th\u1ec3 n\u1eb7ng l\u00e0 cao nh\u1ea5t [1]. Vaccine c\u00fam b\u1ea5t ho\u1ea1t \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o cho t\u1ea5t c\u1ea3 c\u00e1c ph\u1ee5 n\u1eef c\u00f3 thai ho\u1eb7c nh\u1eefng ph\u1ee5 n\u1eef c\u00f3 kh\u1ea3 n\u0103ng s\u1ebd mang thai trong m\u00f9a c\u00fam v\u00e0o b\u1ea5t c\u1ee9 th\u1eddi \u0111i\u1ec3m n\u00e0o c\u1ee7a thai k\u00ec [2,3]. C\u00e1c d\u1eef li\u1ec7u g\u1ea7n \u0111\u00e2y \u1edf Hoa K\u00ec cho th\u1ea5y c\u00f3 kho\u1ea3ng 54% s\u1ed1 ph\u1ee5 n\u1eef \u0111\u01b0\u1ee3c ti\u00eam vaccine BH-HG-UV trong thai k\u00ec v\u00e0 kho\u1ea3ng 49% ph\u1ee5 n\u1eef ti\u00eam vaccine c\u00fam b\u1ea5t ho\u1ea1t tr\u01b0\u1edbc ho\u1eb7c trong thai k\u00ec.<\/p>\n<p>Ngo\u00e0i ra, ng\u01b0\u1eddi ta \u0111ang ti\u1ebfn h\u00e0nh ph\u00e1t tri\u1ec3n c\u00e1c vaccine m\u1edbi ch\u1ed1ng l\u1ea1i li\u00ean c\u1ea7u nh\u00f3m B v\u00e0 virus h\u1ee3p b\u00e0o \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p, c\u00e1c vaccine n\u00e0y c\u00f3 th\u1ec3 \u0111em l\u1ea1i l\u1ee3i \u00edch cho ph\u1ee5 n\u1eef c\u00f3 thai. X\u00e1c \u0111\u1ecbnh th\u1eddi gian ti\u00eam ch\u1ee7ng c\u1ee7a ph\u1ee5 n\u1eef c\u00f3 thai nh\u1eb1m t\u1ed1i \u01b0u ho\u00e1 kh\u1ea3 n\u0103ng b\u1ea3o v\u1ec7 b\u00e0 m\u1eb9 v\u00e0 tr\u1ebb kh\u1ecfi c\u00e1c b\u1ec7nh nhi\u1ec5m tr\u00f9ng l\u00e0 r\u1ea5t quan tr\u1ecdng. B\u00e0i t\u1ed5ng h\u1ee3p n\u00e0y s\u1ebd b\u00e0n lu\u1eadn v\u1ec1 c\u00e1c y\u1ebfu t\u1ed1 c\u1ea7n xem x\u00e9t \u0111\u1ec3 t\u1ed1i \u01b0u ho\u00e1 l\u1ecbch ti\u00eam ch\u1ee7ng \u1edf b\u00e0 m\u1eb9 mang thai.<\/p>\n<h2>Khi n\u00e0o ti\u00eam vaccine l\u00e0 an to\u00e0n nh\u1ea5t?<\/h2>\n<p>Th\u1eddi k\u00ec mang thai g\u1eafn li\u1ec1n v\u1edbi nh\u1eefng thay \u0111\u1ed5i v\u1ec1 ph\u00e1t tri\u1ec3n ph\u00f4i v\u00e0 thai theo th\u1eddi gian c\u1ee5 th\u1ec3. Qu\u00ed \u0111\u1ea7u ti\u00ean v\u00e0 giai \u0111o\u1ea1n \u0111\u1ea7u qu\u00ed th\u1ee9 hai l\u00e0 c\u00e1c th\u1eddi k\u00ec t\u1ea1o ph\u00f4i v\u00e0 h\u00ecnh thai c\u01a1 quan c\u1ee7a thai, nhi\u1ec5m tr\u00f9ng c\u1ee7a m\u1eb9 trong c\u00e1c giai \u0111o\u1ea1n n\u00e0y c\u00f3 th\u1ec3 g\u00e2y nhi\u1ec5m tr\u00f9ng \u1edf thai d\u1eabn t\u1edbi s\u1ea3y thai, b\u1ea5t th\u01b0\u1eddng ph\u00f4i v\u00e0 d\u1ecb t\u1eadt b\u1ea9m sinh. Ti\u00eam ch\u1ee7ng \u1edf giai \u0111o\u1ea1n mang thai s\u1edbm c\u00f3 th\u1ec3 b\u1ea3o v\u1ec7 b\u00e0 m\u1eb9 kh\u1ecfi nhi\u1ec5m tr\u00f9ng s\u1edbm trong thai k\u00ec, l\u00e0m gi\u1ea3m t\u1ec9 l\u1ec7 nhi\u1ec5m tr\u00f9ng trong t\u1eed cung v\u00e0 c\u00e1c tai bi\u1ebfn n\u1eb7ng khi sinh [4]. Tuy nhi\u00ean, c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng v\u1eabn c\u00f2n do d\u1ef1 khi ti\u00eam ch\u1ee7ng trong giai \u0111o\u1ea1n n\u00e0y do v\u1ec1 m\u1eb7t l\u00ed thuy\u1ebft v\u1eabn t\u1ed3n t\u1ea1i nh\u1eefng lo ng\u1ea1i nh\u1ea5t \u0111\u1ecbnh. Tuy nhi\u00ean, ng\u00e0y c\u00e0ng c\u00f3 th\u00eam c\u00e1c b\u1eb1ng ch\u1ee9ng \u1ee7ng h\u1ed9 m\u1ee9c \u0111\u1ed9 an to\u00e0n c\u1ee7a c\u00e1c vaccine ho g\u00e0 v\u00e0 c\u00fam \u0111\u01b0\u1ee3c ti\u00eam trong qu\u00ed \u0111\u1ea7u c\u1ee7a thai k\u00ec [5,6], nh\u01b0 ti\u00eam vaccine ho g\u00e0 trong th\u1eddi gian n\u00e0y kh\u00f4ng g\u00e2y ra d\u1ecb t\u1eadt s\u01a1 sinh (birth defects) [5].<\/p>\n<p>Nhi\u1ec5m tr\u00f9ng trong giai \u0111o\u1ea1n mu\u1ed9n c\u1ee7a qu\u00ed 2 ho\u1eb7c trong qu\u00ed 3 th\u01b0\u1eddng kh\u00f4ng g\u00e2y b\u1ea5t th\u01b0\u1eddng c\u1ea5u tr\u00fac nhi\u1ec1u, v\u00e0 ti\u00eam vaccine trong giai \u0111o\u1ea1n n\u00e0y c\u0169ng kh\u00f4ng li\u00ean quan nhi\u1ec1u \u0111\u1ebfn bi\u1ebfn c\u1ed1 b\u1ea5t l\u1ee3i khi sinh. Do \u0111\u00f3, vi\u1ec7c l\u1ef1a ch\u1ecdn th\u1eddi \u0111i\u1ec3m an to\u00e0n nh\u1ea5t \u0111\u1ec3 ti\u00eam vaccine trong th\u1eddi k\u00ec mang thai c\u1ea7n c\u00e2n b\u1eb1ng gi\u1eefa c\u00e1c y\u1ebfu t\u1ed1 n\u00e0y.<\/p>\n<h2>Th\u1eddi gian n\u00e0o th\u00ec d\u1ec5 m\u1eafc b\u1ec7nh nh\u1ea5t?<\/h2>\n<p>L\u1ecbch ti\u00eam ch\u1ee7ng l\u00ed t\u01b0\u1edbng cho m\u1eb9 c\u1ea7n mang l\u1ea1i kh\u1ea3 n\u0103ng b\u1ea3o v\u1ec7 v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng cao nh\u1ea5t trong giai \u0111o\u1ea1n c\u00f3 kh\u1ea3 n\u0103ng b\u1ecb nhi\u1ec5m tr\u00f9ng t\u0103ng cao nh\u1ea5t. Nh\u01b0 v\u1eady, x\u00e1c \u0111\u1ecbnh \u0111\u1ed1i t\u01b0\u1ee3ng \u0111\u00edch c\u1ea7n ti\u00eam ch\u1ee7ng l\u00e0 v\u00f4 c\u00f9ng thi\u1ebft y\u1ebfu: b\u00e0 m\u1eb9, \u0111\u1ee9a tr\u1ebb hay c\u1ea3 hai. Vi\u1ec7c ti\u00eam vaccine trong th\u1eddi k\u00ec mang thai h\u01b0\u1edbng \u0111\u1ebfn d\u1ef1 ph\u00f2ng nhi\u1ec5m tr\u00f9ng cho m\u1eb9 v\u00e0 tr\u1ebb \u1edf c\u00e1c m\u1ee9c \u0111\u1ed9 kh\u00e1c nhau. V\u00ed d\u1ee5, vaccine c\u00fam \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 b\u1ea3o v\u1ec7 ng\u01b0\u1eddi m\u1eb9 \u0111ang mang thai v\u00e0 \u0111\u1ee9a tr\u1ebb sau khi sinh ra, trong khi vaccine ph\u00f2ng ho g\u00e0, li\u00ean c\u1ea7u nh\u00f3m B v\u00e0 virus h\u1ee3p b\u00e0o \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p ch\u1ee7 y\u1ebfu h\u01b0\u1edbng t\u1edbi b\u1ea3o v\u1ec7 \u0111\u1ee9a tr\u1ebb.<\/p>\n<p>Th\u00eam v\u00e0o \u0111\u00f3, kho\u1ea3ng th\u1eddi gian c\u1eeda s\u1ed5 c\u00f3 nguy c\u01a1 cao nh\u1ea5t m\u1eafc c\u00e1c b\u1ec7nh nhi\u1ec5m tr\u00f9ng d\u1ef1 ph\u00f2ng \u0111\u01b0\u1ee3c b\u1eb1ng vaccine trong th\u1eddi k\u00ec mang thai ho\u1eb7c th\u01a1 \u1ea5u c\u0169ng ph\u1ee5 thu\u1ed9c v\u00e0o c\u0103n nguy\u00ean g\u00e2y b\u1ec7nh m\u00e0 ti\u00eam ch\u1ee7ng nh\u1eafm \u0111\u1ebfn. B\u1ec7nh c\u00fam l\u00e0 n\u1eb7ng nh\u1ea5t \u0111\u1ed1i v\u1edbi ph\u1ee5 n\u1eef c\u00f3 thai \u1edf qu\u00ed 3, trong khi ho g\u00e0 l\u00e0 n\u1eb7ng nh\u1ea5t \u1edf tr\u1ebb s\u01a1 sinh trong v\u00f2ng m\u1ed9t v\u00e0i tu\u1ea7n \u0111\u1ea7u \u0111\u1eddi.<\/p>\n<h2>Th\u1eddi \u0111i\u1ec3m n\u00e0o vaccine c\u00f3 th\u1ec3 t\u1ea1o ra \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch l\u1edbn nh\u1ea5t?<\/h2>\n<p>M\u1ed7i lo\u1ea1i vaccine c\u1ea7n \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh th\u1eddi gian ti\u00eam ch\u1ee7ng cho ph\u1ee5 n\u1eef c\u00f3 thai \u0111\u1ec3 t\u1ea1o ra \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch t\u1ed1t nh\u1ea5t, gi\u00fap t\u1ed1i \u01b0u s\u1ef1 v\u1eadn chuy\u1ec3n kh\u00e1ng th\u1ec3 qua nhau thai sang \u0111\u1ee9a tr\u1ebb v\u00e0 duy tr\u00ec t\u1ea1o kh\u00e1ng th\u1ec3 trong su\u1ed1t giai \u0111o\u1ea1n c\u00f3 kh\u1ea3 n\u0103ng m\u1eafc b\u1ec7nh cao nh\u1ea5t.<\/p>\n<p>Ng\u01b0\u1eddi ta \u0111\u00e3 t\u1eadp trung nghi\u00ean c\u1ee9u n\u1ed3ng \u0111\u1ed9 kh\u00e1ng th\u1ec3 sinh ra do vaccin l\u00fac chuy\u1ec3n d\u1ea1 \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh th\u1eddi gian ti\u00eam ch\u1ee7ng t\u1ed1i \u01b0u. V\u00ed d\u1ee5, ti\u00eam vaccin ho g\u00e0 \u1edf giai \u0111o\u1ea1n s\u1edbm c\u1ee7a qu\u00ed 3 c\u00f3 kh\u1ea3 n\u0103ng t\u1ea1o ra nhi\u1ec1u kh\u00e1ng th\u1ec3 h\u01a1n ch\u1ed1ng ho g\u00e0 l\u00fac sinh h\u01a1n so v\u1edbi ti\u00eam ch\u1ee7ng giai \u0111o\u1ea1n mu\u1ed9n [7]. Ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c cho t\u1ea5t c\u1ea3 c\u00e1c c\u0103n nguy\u00ean g\u00e2y b\u1ec7nh ng\u01b0\u1ee1ng kh\u00e1ng th\u1ec3 t\u1ea1o ra do ti\u00eam ch\u1ee7ng c\u00f3 t\u01b0\u01a1ng quan v\u1edbi s\u1ef1 b\u1ea3o v\u1ec7 c\u01a1 th\u1ec3 ch\u1ed1ng nhi\u1ec5m tr\u00f9ng v\u00e0 b\u1ec7nh t\u1eadt (v\u00ed d\u1ee5, ch\u01b0a x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c ng\u01b0\u1ee1ng cho ho g\u00e0 nh\u01b0ng c\u00f3 r\u1ea5t nhi\u1ec1u bi\u1ebfn t\u01b0\u01a1ng quan \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t cho c\u00e1c type huy\u1ebft thanh kh\u00e1c nhau c\u1ee7a li\u00ean c\u1ea7u nh\u00f3m B). Thi\u1ebfu d\u1eef li\u1ec7u v\u1ec1 t\u01b0\u01a1ng quan nh\u01b0 v\u1eady g\u00e2y tr\u1edf ng\u1ea1i cho vi\u1ec7c \u0111\u01b0a n\u1ed3ng \u0111\u1ed9 kh\u00e1ng th\u1ec3 \u0111\u1eb7c hi\u1ec7u vaccine tr\u1edf th\u00e0nh khuy\u1ebfn c\u00e1o d\u1ef1a tr\u00ean b\u1eb1ng ch\u1ee9ng c\u00f3 \u00fd ngh\u0129a l\u00e2m s\u00e0ng.<\/p>\n<h2>Th\u1eddi \u0111i\u1ec3m n\u00e0o gi\u00fap s\u1eed d\u1ee5ng vaccine t\u1ed1t nh\u1ea5t?<\/h2>\n<p>S\u1eed d\u1ee5ng vaccine \u1edf ph\u1ee5 n\u1eef c\u00f3 thai b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi l\u1ecbch tr\u00ecnh h\u1eb9n kh\u00e1m v\u00e0 can thi\u1ec7p trong thai k\u00ec, th\u1eddi \u0111i\u1ec3m s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i vaccine kh\u00e1c v\u00e0 s\u1ef1 ti\u1ebfp c\u1eadn ch\u0103m s\u00f3c. Ph\u1ed1i h\u1ee3p c\u00e1c l\u1ecbch tr\u00ecnh ti\u00eam ch\u1ee7ng t\u1ed1i \u01b0u v\u00e0 li\u00ean h\u1ec7 th\u01b0\u1eddng xuy\u00ean v\u1edbi chuy\u00ean gia y t\u1ebf c\u00f3 th\u1ec3 l\u00e0m t\u0103ng vi\u1ec7c s\u1eed d\u1ee5ng vaccine \u1edf ph\u1ee5 n\u1eef c\u00f3 thai. Ngo\u00e0i ra, do c\u00f3 ng\u00e0y c\u00e0ng nhi\u1ec1u vaccine, vi\u1ec7c ti\u00eam ch\u1ee7ng c\u00f9ng l\u00fac nhi\u1ec1u lo\u1ea1i vaccine trong m\u1ed9t l\u1ea7n ti\u00eam ch\u1ee7ng c\u0169ng l\u00e0m t\u0103ng s\u1eed d\u1ee5ng vaccine.<\/p>\n<p>Ti\u1ebfp c\u1eadn v\u1edbi d\u1ecbch v\u1ee5 ti\u00eam ch\u1ee7ng b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi c\u00e1c y\u1ebfu t\u1ed1 \u0111\u1ecba ph\u01b0\u01a1ng v\u00e0 kinh t\u1ebf. Nhu c\u1ea7u chi tr\u1ea3 cho vaccine v\u00e0 gi\u00e1 th\u00e0nh ti\u00eam ch\u1ee7ng l\u00e0 c\u00e1c tr\u1edf ng\u1ea1i cho vi\u1ec7c ti\u00eam ch\u1ee7ng. \u1ede Hoa K\u00ec, t\u1ec9 l\u1ec7 s\u1eed d\u1ee5ng vaccine c\u00fam b\u1ea5t ho\u1ea1t \u1edf ph\u1ee5 n\u1eef kh\u00f4ng c\u00f3 b\u1ea3o hi\u1ec3m y t\u1ebf th\u1ea5p h\u01a1n (kho\u1ea3ng 24%) so v\u1edbi ph\u1ee5 n\u1eef c\u00f3 b\u1ea3o hi\u1ec3m c\u00f4ng l\u1eadp (31%) ho\u1eb7c t\u01b0 nh\u00e2n ho\u1eb7c qu\u00e2n \u0111\u1ed9i (40%) [8].<\/p>\n<h2>C\u1ea7n c\u00f3 c\u00e1c nghi\u00ean c\u1ee9u \u0111\u1ec3 t\u1ed1i \u01b0u ho\u00e1 th\u1eddi \u0111i\u1ec3m ti\u00eam ch\u1ee7ng trong th\u1eddi k\u00ec mang thai<\/h2>\n<p>C\u1ea7n th\u00eam c\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 c\u1ee7a vaccine s\u1eed d\u1ee5ng trong c\u00e1c th\u1eddi \u0111i\u1ec3m kh\u00e1c nhau c\u1ee7a thai k\u00ec. \u0110\u1ec3 nghi\u00ean c\u1ee9u thu\u1eadn l\u1ee3i c\u1ea7n c\u00f3 c\u00e1c nghi\u00ean c\u1ee9u quan s\u00e1t v\u00e0 th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng l\u1edbn, trong \u0111\u00f3 ti\u00eam ch\u1ee7ng \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh t\u1ea1i c\u00e1c th\u1eddi \u0111i\u1ec3m kh\u00e1c nhau trong thai k\u00ec. C\u00f3 th\u1ec3 g\u1eb7p kh\u00f3 kh\u0103n khi x\u00e1c \u0111\u1ecbnh hi\u1ec7u qu\u1ea3 do m\u1ed9t s\u1ed1 b\u1ec7nh d\u1ef1 ph\u00f2ng \u0111\u01b0\u1ee3c b\u1eb1ng vaccine c\u00f3 t\u1ea7n su\u1ea5t hi\u1ec7n m\u1eafc kh\u00f4ng cao trong qu\u1ea7n th\u1ec3. M\u1eb7c d\u00f9 t\u1ec9 su\u1ea5t m\u1eafc m\u1edbi ho g\u00e0 l\u00e0 cao nh\u1ea5t \u1edf tr\u1ebb d\u01b0\u1edbi 3 th\u00e1ng tu\u1ed5i (l\u00ean \u0111\u1ebfn 247\/ 100.000) [9], tr\u1edf ng\u1ea1i l\u00e0 \u1edf ch\u1ed7 x\u00e1c \u0111\u1ecbnh hi\u1ec7u qu\u1ea3 ph\u1ee5 thu\u1ed9c th\u1eddi gian c\u1ee7a vaccine \u1edf tr\u1ebb sau khi ti\u00eam ch\u1ee7ng ho g\u00e0 cho m\u1eb9 do nghi\u00ean c\u1ee9u n\u00e0y \u0111\u00f2i h\u1ecfi c\u1ee1 m\u1eabu l\u1edbn.<\/p>\n<p>C\u00e1c nh\u00e0 nghi\u00ean c\u1ee9u c\u1ea7n c\u1ed1 g\u1eafng m\u00f4 t\u1ea3 to\u00e0n di\u1ec7n \u0111\u1eb7c \u0111i\u1ec3m \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch ch\u1ee9c n\u0103ng sau khi ti\u00eam ch\u1ee7ng trong thai k\u00ec v\u00e0 x\u00e1c \u0111\u1ecbnh c\u00e1c t\u01b0\u01a1ng quan v\u1ec1 mi\u1ec5n d\u1ecbch b\u1ea3o v\u1ec7 c\u01a1 th\u1ec3 kh\u1ecfi nhi\u1ec5m tr\u00f9ng v\u00e0 b\u1ec7nh t\u1eadt. C\u00f3 th\u1ec3 k\u1ebft h\u1ee3p c\u00e1c k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m mi\u1ec5n d\u1ecbch n\u00e0y v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p sinh ho\u00e1 h\u1ec7 th\u1ed1ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 vi\u1ec7c ti\u00eam ch\u1ee7ng \u1edf c\u00e1c tu\u1ed5i thai kh\u00e1c nhau v\u00e0 x\u00e1c \u0111\u1ecbnh th\u1eddi gian ti\u00eam ch\u1ee7ng t\u1ed1i \u01b0u c\u00f3 th\u1ec3 sinh \u0111\u00e1p \u1ee9ng b\u1ea3o v\u1ec7 t\u1ed1i \u01b0u. C\u0169ng c\u1ea7n nghi\u00ean c\u1ee9u hi\u1ec7u qu\u1ea3 chi ph\u00ed c\u1ee7a c\u00e1c ch\u01b0\u01a1ng tr\u00ecnh ti\u00eam ch\u1ee7ng \u1edf b\u00e0 m\u1eb9 mang thai \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o cho c\u00e1c th\u1eddi gian c\u1eeda s\u1ed5 kh\u00e1c nhau trong thai k\u00ec.<\/p>\n<p>C\u00e1c nh\u00e0 l\u00e0m ch\u00ednh s\u00e1ch c\u1ea7n xem x\u00e9t hi\u1ec7u qu\u1ea3 ph\u1ee5 thu\u1ed9c th\u1eddi gian, hi\u1ec7u qu\u1ea3 c\u1ee7a vaccine, \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch \u1edf b\u00e0 m\u1eb9 v\u00e0 \u0111\u1ee9a tr\u1ebb c\u0169ng nh\u01b0 s\u1eed d\u1ee5ng vaccine khi \u0111\u01b0a ra khuy\u1ebfn c\u00e1o v\u1ec1 th\u1eddi gian ti\u00eam ch\u1ee7ng cho ph\u1ee5 n\u1eef c\u00f3 thai. Khi ch\u00ednh s\u00e1ch ti\u00eam ch\u1ee7ng cho ph\u1ee5 n\u1eef mang thai \u0111\u01b0\u1ee3c \u1ee7ng h\u1ed9 v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng \u00e1p d\u1ee5ng \u0111\u01b0\u1ee3c cho c\u00e1c vaccine m\u1edbi, m\u1edf r\u1ed9ng t\u1ed1i \u0111a ch\u00ednh s\u00e1ch n\u00e0y s\u1ebd b\u1ea3o \u0111\u1ea3m l\u1ee3i \u00edch cao nh\u1ea5t cho c\u00e1c b\u00e0 m\u1eb9 mang thai v\u00e0 con c\u1ee7a h\u1ecd.<\/p>\n<h2>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<p>1. Munoz FM, Bond NH, Maccato M, et al. Safety and immunogenicity of tetanus diphtheria and acellular pertussis (Tdap) immunization during pregnancy in mothers and infants: a randomized clinical trial. JAMA. 2014;311(17):1760-1769. doi:10.1001\/jama.2014.3633<br \/>\n2. ACOG committee opinion no. 741 summary: maternal immunization. Obstet Gynecol. 2018;131(6):1188-1191. doi:10.1097\/AOG.0000000000002665<br \/>\n3. Kahn KE, Black CL, Ding H, et al. Influenza and Tdap vaccination coverage among pregnant women\u2014United States, April 2018. MMWR Morb Mortal Wkly Rep. 2018;67(38):1055-1059. doi:10.15585\/mmwr.mm6738a3<br \/>\n4. H\u00e5berg SE, Trogstad L, Gunnes N, et al. Risk of fetal death after pandemic influenza virus infection or vaccination. N Engl J Med. 2013;368(4):333-340. doi:10.1056\/NEJMoa1207210<br \/>\n5. DeSilva M, Vazquez-Benitez G, Nordin JD, et al. Tdap vaccination during pregnancy and microcephaly and other structural birth defects in offspring. JAMA. 2016;316(17):1823-1825. doi:10.1001\/jama.2016.14432<br \/>\n6. McHugh L, , Marshall HS, Perrett KP, et al. The safety of influenza and pertussis vaccination in pregnancy in a cohort of Australian mother-infant pairs, 2012-2015: the FluMum Study. Clin Infect Dis. 2018;68(3):402-408. doi:10.1093\/cid\/ciy517<br \/>\n7. Healy CM, Rench MA, Swaim LS, et al. Association between third-trimester tdap immunization and neonatal pertussis antibody concentration. JAMA. 2018;320(14):1464-1470. doi:10.1001\/jama.2018.14298<br \/>\n8. Ding H, Black CL, Ball SW, et al. 2017. Pregnant women and flu vaccination, internet panel survey, United States, November 2017. <a href=\"https:\/\/www.cdc.gov\/flu\/fluvaxview\/pregnant-women-nov2017.htm\" rel=\"noopener\">https:\/\/www.cdc.gov\/flu\/fluvaxview\/pregnant-women-nov2017.htm<\/a> . Accessed January 1, 2019.<br \/>\n9. Masseria C, Martin CK, Krishnarajah G, Becker LK, Buikema A, Tan TQ. Incidence and burden of pertussis among infants less than 1 year of age. Pediatr Infect Dis J. 2017;36(3):e54-e61. doi:10.1097\/INF.0000000000001440.<\/p>\n<p>T\u00e1c gi\u1ea3:\u00a0 Bahaa Abu-Raya; Kathryn M. Edwards JAMA. 2019;321(10):935-936. doi:10.1001\/jama.2019.0703<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ti\u00eam ch\u1ee7ng trong th\u1eddi k\u00ec mang thai l\u00e0 m\u1ed9t bi\u1ec7n ph\u00e1p quan tr\u1ecdng gi\u00fap b\u1ea3o v\u1ec7 \u0111\u1ee9a tr\u1ebb kh\u1ecfi c\u00e1c t\u00ecnh tr\u1ea1ng nhi\u1ec5m tr\u00f9ng \u0111e do\u1ea1 t\u00ednh m\u1ea1ng trong 1 th\u00e1ng \u0111\u1ea7u \u0111\u1eddi. Vi\u1ec7c l\u00e0m n\u00e0y gi\u00fap t\u0103ng c\u01b0\u1eddng s\u1ef1 v\u1eadn chuy\u1ec3n c\u00e1c kh\u00e1ng th\u1ec3 \u0111\u1eb7c hi\u1ec7u v\u1edbi vaccine t\u1eeb m\u1eb9 qua nhau thai, \u0111em [&#8230;]\n","protected":false},"author":1,"featured_media":5001,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-5000","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\/5000","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=5000"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/5000\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/5001"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=5000"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=5000"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=5000"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}