Hỏi và trả lời


Họ Tên: Vu Tuan Anh

Câu hỏi:
Cac bac si cho toi hoi rang: o vien co the sieu am de phat hien di tat thai nhi khong? vi vo toi bi mac RUBELLA vao tuan thu 15 - 16 cua thai nhi. Ma o ngoai Bac dong benh nhan qua van chua kham ra van de gi ca? Vo chong toi rat lo lang. Duoc ban be gioi thieu ve quy vien nen rat hy vong vao su giup do cua cac bac si. Toi chan thanh cam on
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Trả lời:

Chào Anh

            Hiện tại ở bệnh viện chúng tôi vẫn thường quy triển khai siêu âm 4D và các xét nghiệm để tầm soát, phát hiện các dị tật bẩm sinh thai nhi như dị dạng ống thần kinh, bệnh lý Down, các dị dạng về hình thái thai nhi (sứt môi hở hàm ếch, bụng cóc, dị dạng não, dị dạng ở tạng, dị tật ở chi, dị tật buồng tim, van tim… )

            Đối với trường hợp của chị nhà, mắc Rubella vào tuần thứ 15 – 16 của thai kỳ thì nguy cơ bị bệnh và dị tật ở thai nhi là thấp; tuy nhiên không phải là không có khả năng bị mắc bệnh. Các dị tật mắc phải vào giai đoạn này thường ít nặng nề hơn so với 3 tháng đầu của thai kỳ và các tổn thương có thể gặp là viêm kết mạc, tổn thương võng mạc, đục thuỷ tinh thể, tổn thương tai và có thể gây câm điếc sau sinh, tổn thương thần kinh, tổn thương viêm cơ tim, tổn thương van tim nhẹ… Đáng tiếc các tổn thương này hiện rất khó có thể phát hiện bằng siêu âm trong quá trình khám và quản lý thai. Ở nước ta hiện nay phương tiện để chẩn đoán thai nhi có chắc chắn nhiễm Rubella hay không vẫn chưa thực hiện được.  Chính vì vậy hiện tại khi có chẩn đoán người mẹ đã nhiễm Rubella thì tốt nhất là ngừng thai nghén (trong thời kỳ thai <16 tuần tuổi). Nếu giữ thai thì mong đợi một tiến triển tốt đi kèm khám và quản lý thai cẩn thận để sớm phát hiện bất thường và có thảo luận giữa thầy thuốc và người bệnh về hướng xử trí phù hợp.

Theo tôi, hiện nay có 2 bệnh viện đầu ngành về Phụ Sản sẽ có khả năng tầm soát, tư vấn và xử trí tốt nhất cho chị nhà là: Bệnh viện Phụ Sản Trung Ương (tại Hà Nội) và Bệnh viện Từ Dũ (TPHCM). Anh nên sắp xếp đưa chị đến khám và tư vấn ở một trong hai bệnh viện này.

            Cảm ơn anh chị đã tin tưởng vào dịch vụ của bệnh viện chúng tôi.

Chúc anh chị và cháu may mắn, sức khoẻ.

Ts.Bs. Trần Quang Tuấn

Phó Giám Đốc

Phụ trách khối Ngoại - Sản


 
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