{"id":1053,"date":"2024-02-17T06:52:00","date_gmt":"2024-02-16T23:52:00","guid":{"rendered":"https:\/\/cdha.edu.vn\/cdha\/?p=1053"},"modified":"2024-02-14T13:49:31","modified_gmt":"2024-02-14T06:49:31","slug":"single-left-superior-vena-cava","status":"publish","type":"post","link":"https:\/\/cdha.edu.vn\/cdha\/single-left-superior-vena-cava\/","title":{"rendered":"Single left superior vena cava"},"content":{"rendered":"\n

Single left superior vena cava
<\/strong>T\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean tr\u00e1i \u0111\u1ed9c nh\u1ea5t
T\u1ed3n t\u1ea1i t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean tr\u00e1i k\u00e8m kh\u00f4ng c\u00f3 t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean ph\u1ea3i<\/em><\/p>\n\n\n\n

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Vladimir Lemaire (1), Frantisek Grochal (2), Teresa Randall (1), Susan Hovinen (1), Patricia Santiago-Mu\u00f1oz (1), Robyn Horsager-Boehrer (1)
(1) UT Southwestern Medical Center, Dallas, Texas, United States of America; (2) Femicare, Center of prenatal ultrasonographic diagnostics, Martin, Slovakia.<\/em><\/p>\n\n\n\n

Posting Dates:<\/strong>\u00a0Jan 15, 2024 – Jan 30, 2024<\/p>\n\n\n\n

Case of the Week #597<\/a><\/p>\n\n\n\n

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N\u1ed8I DUNG T\u00d3M T\u1eaeT<\/strong><\/p>\n\n\n\n

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  1. T\u1ed3n t\u1ea1i TMCT tr\u00e1i \u0111i k\u00e8m v\u1edbi kh\u00f4ng c\u00f3 TMC ph\u1ea3i l\u00e0 m\u1ed9t b\u1ea5t th\u01b0\u1eddng c\u1ef1c k\u1ef3 hi\u1ebfm g\u1eb7p<\/li>\n\n\n\n
  2. D\u1ea5u hi\u1ec7u si\u00eau \u00e2m: Th\u1ea5y \u0110MP (ho\u1eb7c quai \u00d4\u0110M) n\u1eb1m gi\u1eefa 2 m\u1ea1ch m\u00e1u: b\u00ean tr\u00e1i l\u00e0 t\u1ed3n t\u1ea1i TMCT tr\u00e1i, b\u00ean ph\u1ea3i l\u00e0 \u0110MC (ho\u1eb7c cung \u0110MC). C\u1ea7n tr\u00e1nh nh\u1ea7m l\u1eabn kh\u00ed qu\u1ea3n v\u1edbi TMC ph\u1ea3i.<\/li>\n\n\n\n
  3. Ph\u00e2n bi\u1ec7t v\u1edbi b\u1ea5t th\u01b0\u1eddng h\u1ed3i l\u01b0u TM ph\u1ed5i to\u00e0n ph\u1ea7n tr\u00ean tim (type 1) d\u1ef1a v\u00e0o TM c\u00e1nh tay \u0111\u1ea7u d\u00e3n.<\/li>\n\n\n\n
  4. Kh\u00f4ng c\u00f3 TMC b\u00ean ph\u1ea3i th\u01b0\u1eddng \u0111i k\u00e8m v\u1edbi h\u1ed9i ch\u1ee9ng \u0111\u1ed3ng d\u1ea1ng nh\u01b0ng n\u1ebfu \u0111\u01a1n \u0111\u1ed9c n\u00f3 c\u00f3 th\u01b0\u1eddng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng, ti\u00ean l\u01b0\u1ee3ng t\u1ed1t.<\/li>\n<\/ol>\n\n\n\n
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    M\u1ed9t ph\u1ee5 n\u1eef 23 tu\u1ed5i, G1P01<\/a><\/sup>, \u0111\u1ebfn \u0111\u01a1n v\u1ecb b\u00e0 m\u1eb9 b\u00e0o thai c\u1ee7a ch\u00fang t\u00f4i l\u00fac 22 tu\u1ea7n, 3 ng\u00e0y \u0111\u1ec3 kh\u1ea3o s\u00e1t gi\u1ea3i ph\u1eabu thai nhi. Thai nhi l\u00e0 n\u1eef v\u1edbi x\u00e9t nghi\u1ec7m ti\u1ec1n s\u1ea3n kh\u00f4ng x\u00e2m l\u1ea5n (NIPT) nguy c\u01a1 th\u1ea5p. Nh\u1eefng ph\u00e1t hi\u1ec7n sau \u0111\u00e2y \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn:<\/p>\n\n\n

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    \"\"\/<\/figure>\n<\/div>\n\n
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    \"\"\/<\/figure>\n<\/div>\n\n
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    \"\"<\/figure>\n<\/div>\n\n
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    \"\"\/<\/figure>\n<\/div>\n\n
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    \"\"\/
    H\u00ecnh 5: m\u1eb7t c\u1eaft \u0111\u01b0\u1eddng ra th\u1ea5t ph\u1ea3i l\u00fac 35 tu\u1ea7n<\/figcaption><\/figure>\n<\/div>\n\n
    \n
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    H\u00ecnh 6: m\u1eb7t c\u1eaft 3 m\u1ea1ch m\u00e1u l\u00fac 35 tu\u1ea7n<\/figcaption><\/figure>\n<\/div>\n\n
    \n
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    H\u00ecnh 7: m\u1eb7t c\u1eaft 3 m\u1ea1ch m\u00e1u kh\u00ed qu\u1ea3n \u1edf tu\u1ea7n 35<\/figcaption><\/figure>\n<\/div>\n\n
    \n
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    H\u00ecnh 8<\/figcaption><\/figure>\n<\/div>\n\n\n

    Ch\u00fang t\u00f4i tr\u00ecnh b\u00e0y m\u1ed9t tr\u01b0\u1eddng h\u1ee3p t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean b\u00ean tr\u00e1i \u0111\u1ed9c nh\u1ea5t2<\/a><\/sup>. \u0110\u00e2y l\u00e0 m\u1ed9t ph\u00e1t hi\u1ec7n \u0111\u01a1n \u0111\u1ed9c. Kh\u00f4ng t\u00ecm th\u1ea5y b\u1ea5t th\u01b0\u1eddng n\u00e0o kh\u00e1c t\u1ea1i tim ho\u1eb7c ngo\u00e0i tim. Ch\u1ea9n \u0111o\u00e1n c\u1ee7a ch\u00fang t\u00f4i \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c nh\u1eadn sau sinh.<\/p>\n\n\n\n

    Si\u00eau \u00e2m cho th\u1ea5y v\u1ecb th\u1ebf thai l\u00e0 situs solitus. \u1ede m\u1eb7t c\u1eaft b\u1ed1n bu\u1ed3ng, t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean b\u00ean tr\u00e1i \u0111\u01b0\u1ee3c nh\u00ecn th\u1ea5y tr\u00ean m\u1eb7t c\u1eaft ngang \u1edf b\u1edd c\u1ee7a nh\u0129 tr\u00e1i. Hai t\u0129nh m\u1ea1ch ph\u1ed5i c\u0169ng \u0111\u01b0\u1ee3c nh\u00ecn th\u1ea5y \u0111\u1ed5 v\u00e0o nh\u0129 tr\u00e1i, \u0111i\u1ec1u n\u00e0y gi\u00fap lo\u1ea1i tr\u1eeb b\u1ea5t th\u01b0\u1eddng h\u1ed3i l\u01b0u t\u0129nh m\u1ea1ch ph\u1ed5i to\u00e0n ph\u1ea7n tr\u00ean tim type 13<\/a><\/sup>. \u1ede m\u1eb7t c\u1eaft \u0111\u01b0\u1eddng ra th\u1ea5t ph\u1ea3i (RVOT), m\u1eb7t c\u1eaft 3 m\u1ea1ch m\u00e1u (3VV) v\u00e0 m\u1eb7t c\u1eaft 3 m\u1ea1ch m\u00e1u-kh\u00ed qu\u1ea3n (3VTV), thay v\u00ec nh\u00ecn th\u1ea5y 4 m\u1ea1ch m\u00e1u v\u1edbi m\u1ea1ch m\u00e1u b\u1ed5 sung \u1edf b\u00ean tr\u00e1i c\u1ee7a th\u00e2n \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i, ch\u1ec9 th\u1ea5y ba m\u1ea1ch m\u00e1u v\u1edbi ph\u00e2n b\u1ed1 b\u1ea5t th\u01b0\u1eddng. T\u1eeb tr\u00e1i sang ph\u1ea3i l\u00e0, t\u1ed3n t\u1ea1i t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean tr\u00e1i, quai \u1ed1ng \u0111\u1ed9ng m\u1ea1ch v\u00e0 quai \u0111\u1ed9ng m\u1ea1ch ch\u1ee7. T\u0129nh m\u1ea1ch v\u00f4 danh c\u0169ng \u0111\u01b0\u1ee3c ghi nh\u1eadn l\u00e0 ch\u1ea1y t\u1eeb ph\u1ea3i sang tr\u00e1i, thay v\u00ec qu\u1ef9 \u0111\u1ea1o t\u1eeb tr\u00e1i sang ph\u1ea3i th\u00f4ng th\u01b0\u1eddng. Xoang v\u00e0nh b\u1ecb gi\u00e3n khi th\u1ef1c hi\u1ec7n si\u00eau \u00e2m \u0111\u00e1nh gi\u00e1 t\u0103ng tr\u01b0\u1edfng thai l\u00fac 35 tu\u1ea7n 6 ng\u00e0y.<\/p>\n\n\n

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    H\u00ecnh 5: m\u1eb7t c\u1eaft \u0111\u01b0\u1eddng ra th\u1ea5t ph\u1ea3i l\u00fac 35 tu\u1ea7n<\/figcaption><\/figure>\n<\/div>\n\n
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    H\u00ecnh 6: m\u1eb7t c\u1eaft 3 m\u1ea1ch m\u00e1u l\u00fac 35 tu\u1ea7n<\/figcaption><\/figure>\n<\/div>\n\n
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    H\u00ecnh 7: M\u1eb7t c\u1eaft 3 m\u1ea1ch kh\u00ed qu\u1ea3n \u1edf tu\u1ea7n 35. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 kh\u00f4ng nh\u1ea7m l\u1eabn kh\u00ed qu\u1ea3n v\u1edbi t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean b\u00ean ph\u1ea3i.<\/figcaption><\/figure>\n<\/div>\n\n
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    H\u00ecnh 8: Xoang v\u00e0nh gi\u00e3n \u1edf tu\u1ea7n 35<\/figcaption><\/figure>\n<\/div>\n\n
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    H\u00ecnh v\u1ebd s\u01a1 \u0111\u1ed3 m\u1eb7t c\u1eaft b\u1ed1n bu\u1ed3ng cho th\u1ea5y LSVC tr\u00ean m\u1eb7t c\u1eaft ngang n\u1eb1m \u1edf b\u1edd c\u1ee7a t\u00e2m nh\u0129 tr\u00e1i.
    <\/figcaption><\/figure>\n<\/div>\n\n
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    H\u00ecnh \u1ea3nh si\u00eau \u00e2m t\u01b0\u01a1ng \u1ee9ng l\u00fac thai 22 tu\u1ea7n. (l\u01b0u \u00fd v\u1ecb th\u1ebf thai ng\u01b0\u1ee3c so v\u1edbi h\u00ecnh s\u01a1 \u0111\u1ed3, xem th\u00eam h\u00ecnh \u1edf d\u01b0\u1edbi \u0111\u1ec3 \u0111\u1ed1i chi\u1ebfu)<\/figcaption><\/figure>\n<\/div>\n\n
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    Xoay h\u00ecnh l\u1ea1i cho d\u1ec5 nh\u00ecn<\/figcaption><\/figure>\n<\/div>\n\n
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    M\u1eb7t c\u1eaft b\u1ed1n bu\u1ed3ng v\u1edbi Doppler m\u00e0u.<\/figcaption><\/figure>\n<\/div>\n\n
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    \u0110\u01b0\u1eddng ra th\u1ea5t ph\u1ea3i cho th\u1ea5y ba m\u1ea1ch m\u00e1u c\u00f3 h\u00ecnh d\u1ea1ng b\u1ea5t th\u01b0\u1eddng. LSVC, \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i v\u00e0 \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean \u0111\u01b0\u1ee3c nh\u00ecn th\u1ea5y t\u1eeb tr\u00e1i sang ph\u1ea3i.
    <\/figcaption><\/figure>\n<\/div>\n\n
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    H\u00ecnh 5 S\u01a1 \u0111\u1ed3 m\u1eb7t c\u1eaft ba m\u1ea1ch m\u00e1u-kh\u00ed qu\u1ea3n cho th\u1ea5y s\u1ef1 ph\u00e2n b\u1ed1 b\u1ea5t th\u01b0\u1eddng c\u1ee7a c\u00e1c m\u1ea1ch m\u00e1u. LSVC, quai \u1ed1ng \u0111\u1ed9ng m\u1ea1ch v\u00e0 quai \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u0111\u01b0\u1ee3c nh\u00ecn th\u1ea5y t\u1eeb tr\u00e1i sang ph\u1ea3i.
    <\/figcaption><\/figure>\n<\/div>\n\n
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    H\u00ecnh 6 H\u00ecnh \u1ea3nh si\u00eau \u00e2m t\u01b0\u01a1ng \u1ee9ng l\u00fac thai 22 tu\u1ea7n. L\u01b0u \u00fd h\u00ecnh n\u00e0y ng\u01b0\u1ee3c b\u00ean so v\u1edbi h\u00ecnh s\u01a1 \u0111\u1ed3<\/figcaption><\/figure>\n<\/div>\n\n
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    Xoay h\u00ecnh l\u1ea1i cho d\u1ec5 nh\u00ecn<\/figcaption><\/figure>\n<\/div>\n\n\n

    TH\u1ea2O LU\u1eacN<\/strong><\/p>\n\n\n\n

    Trong qu\u00e1 tr\u00ecnh t\u1ea1o ph\u00f4i, d\u1eabn l\u01b0u t\u0129nh m\u1ea1ch h\u1ec7 th\u1ed1ng bao g\u1ed3m hai c\u1eb7p t\u0129nh m\u1ea1ch ch\u00ednh. C\u00e1c t\u0129nh m\u1ea1ch ch\u00ednh ph\u00eda tr\u01b0\u1edbc d\u1eabn l\u01b0u ph\u1ea7n \u0111\u1ea7u c\u1ee7a ph\u00f4i (v\u1ec1 tim) v\u00e0 c\u00e1c t\u0129nh m\u1ea1ch ch\u00ednh ph\u00eda sau d\u1eabn l\u01b0u ph\u1ea7n \u0111u\u00f4i c\u1ee7a ph\u00f4i (v\u1ec1 tim). Khi thai \u0111\u01b0\u1ee3c 8 tu\u1ea7n, t\u0129nh m\u1ea1ch ch\u00ednh ph\u00eda tr\u01b0\u1edbc b\u00ean ph\u1ea3i t\u1ea1o th\u00e0nh t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean b\u00ean ph\u1ea3i v\u00e0 t\u0129nh m\u1ea1ch c\u00e1nh tay \u0111\u1ea7u tr\u00e1i, trong khi t\u0129nh m\u1ea1ch ch\u00ednh ph\u00eda tr\u01b0\u1edbc b\u00ean tr\u00e1i tho\u00e1i h\u00f3a tr\u1edf th\u00e0nh d\u00e2y ch\u1eb1ng Marshall. S\u1ef1 tho\u00e1i h\u00f3a c\u1ee7a t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00e1i b\u1ecb th\u1ea5t b\u1ea1i d\u1eabn \u0111\u1ebfn h\u00ecnh th\u00e0nh t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean tr\u00e1i, th\u01b0\u1eddng ch\u1ea1y gi\u1eefa ti\u1ec3u nh\u0129 tr\u00e1i v\u00e0 c\u00e1c t\u0129nh m\u1ea1ch ph\u1ed5i tr\u00e1i r\u1ed3i \u0111\u1ed5 v\u00e0o xoang v\u00e0nh d\u00e3n. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p hi\u1ebfm hoi, t\u0129nh m\u1ea1ch ch\u1ee7 ch\u00ednh ph\u00eda tr\u01b0\u1edbc b\u00ean ph\u1ea3i b\u1ecb tho\u00e1i h\u00f3a. \u0110i\u1ec1u n\u00e0y d\u1eabn \u0111\u1ebfn v\u1eafng m\u1eb7t t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean b\u00ean ph\u1ea3i \u0111i k\u00e8m v\u1edbi t\u1ed3n t\u1ea1i t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean b\u00ean tr\u00e1i. M\u1ed9t t\u00ecnh tr\u1ea1ng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean b\u00ean tr\u00e1i \u0111\u1ed9c nh\u1ea5t.<\/p>\n\n\n\n

    Theo b\u00e1o c\u00e1o c\u1ee7a Guzzetti v\u00e0 c\u1ed9ng s\u1ef1, t\u1ed3n t\u1ea1i t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean b\u00ean tr\u00e1i \u0111i k\u00e8m v\u1edbi v\u1eafng m\u1eb7t t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean b\u00ean ph\u1ea3i l\u00e0 m\u1ed9t s\u1ef1 k\u1ebft h\u1ee3p c\u1ef1c k\u1ef3 hi\u1ebfm g\u1eb7p, x\u1ea3y ra \u1edf 0,05 \u0111\u1ebfn 0,1% tr\u01b0\u1eddng h\u1ee3p situs solitus.<\/p>\n\n\n\n

    Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t bao g\u1ed3m t\u1ed3n t\u1ea1i t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean hai b\u00ean v\u00e0 b\u1ea5t th\u01b0\u1eddng h\u1ed3i l\u01b0u t\u0129nh m\u1ea1ch ph\u1ed5i to\u00e0n ph\u1ea7n, tr\u00ean tim type 1. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 kh\u00f4ng \u0111\u01b0\u1ee3c nh\u1ea7m l\u1eabn kh\u00ed qu\u1ea3n v\u1edbi t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean b\u00ean ph\u1ea3i. Tr\u01b0\u1eddng h\u1ee3p c\u00f3 t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean hai b\u00ean, t\u0129nh m\u1ea1ch c\u00e1nh tay \u0111\u1ea7u tr\u00e1i th\u01b0\u1eddng kh\u00f4ng \u0111\u01b0\u1ee3c nh\u00ecn th\u1ea5y. Trong khi b\u1ea5t th\u01b0\u1eddng h\u1ed3i l\u01b0u t\u0129nh m\u1ea1ch ph\u1ed5i to\u00e0n ph\u1ea7n, tr\u00ean tim lo\u1ea1i 1, t\u0129nh m\u1ea1ch c\u00e1nh tay \u0111\u1ea7u tr\u00e1i s\u1ebd b\u1ecb gi\u00e3n.<\/p>\n\n\n\n

    Kh\u00f4ng c\u00f3 t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean b\u00ean ph\u1ea3i l\u00e0 \u0111\u1eb7c \u0111i\u1ec3m th\u01b0\u1eddng g\u1eb7p c\u1ee7a h\u1ed9i ch\u1ee9ng \u0111\u1ed3ng d\u1ea1ng. Tuy nhi\u00ean, n\u1ebfu \u0111\u01a1n \u0111\u1ed9c, t\u00ecnh tr\u1ea1ng n\u00e0y th\u01b0\u1eddng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng v\u00e0 kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn huy\u1ebft \u0111\u1ed9ng.<\/p>\n\n\n

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    H\u00ecnh 7 S\u01a1 \u0111\u1ed3 t\u1ed3n t\u1ea1i t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean tr\u00e1i th\u01b0\u1eddng g\u1eb7p (t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean hai b\u00ean).<\/figcaption><\/figure>\n<\/div>\n\n
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    H\u00ecnh 8 H\u00ecnh \u1ea3nh si\u00eau \u00e2m t\u01b0\u01a1ng \u1ee9ng c\u1ee7a thai nhi c\u00f3 t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean hai b\u00ean.<\/figcaption><\/figure>\n<\/div>\n\n\n
    \"\"\/
    Xoay l\u1ea1i h\u00ecnh cho d\u1ec5 nh\u00ecn<\/figcaption><\/figure>\n\n\n\n

    M\u1ed9t s\u1ed1 l\u01b0u \u00fd:<\/strong> <\/p>\n\n\n

    1. Mang thai l\u1ea7n \u0111\u1ea7u, ch\u01b0a sinh l\u1ea7n n\u00e0o \u21a9\ufe0e<\/a><\/li>
    2. T\u1ed3n t\u1ea1i t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean b\u00ean tr\u00e1i k\u00e8m kh\u00f4ng c\u00f3 t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean b\u00ean ph\u1ea3i \u21a9\ufe0e<\/a><\/li>
    3. C\u00f3 4 th\u1ec3 TAPVC: type I: tr\u00ean tim (hay g\u1eb7p nh\u1ea5t), type II: t\u1ea1i tim, type III: d\u01b0\u1edbi tim, type IV: h\u1ed7n h\u1ee3p.
      Type I<\/strong>: tr\u00ean tim hay g\u1eb7p nh\u1ea5t. TMP n\u1ed1i v\u1edbi \u1ed1ng g\u00f3p ph\u00eda sau nh\u0129 tr\u00e1i, theo TM \u0111\u1ee9ng d\u1ecdc n\u1ed1i v\u1edbi TM v\u00f4 danh.
      Type II<\/strong>: t\u1ea1i tim. TM ph\u1ed5i n\u1ed1i v\u1edbi xoang v\u00e0nh d\u00e3n ho\u1eb7c tr\u1ef1c ti\u1ebfp th\u00e0nh sau nh\u0129 ph\u1ea3i.
      Type III<\/strong>: d\u01b0\u1edbi tim. TMP n\u1ed1i v\u1edbi TM \u0111\u1ee9ng d\u1ecdc xuy\u00ean qua c\u01a1 ho\u00e0nh k\u1ebft n\u1ed1i v\u1edbi TM gan. Th\u1ec3 n\u00e0y nguy hi\u1ec3m v\u00ec c\u00f3 th\u1ec3 b\u1ecb ch\u00e8n \u00e9p.

      C\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a b\u1ea5t th\u01b0\u1eddng h\u1ed3i l\u01b0u TMP to\u00e0n ph\u1ea7n (Total Anomalous Pumonary Venous Connections – TAPVC)
      1. Kh\u00f4ng th\u1ea5y d\u00f2ng ch\u1ea3y c\u1ee7a TMP v\u00e0o NT
      2. Nh\u0129 tr\u00e1i nh\u1ecf
      3. Tim ph\u1ea3i > tim tr\u00e1i
      4. \u0110MP > \u0110MC
      5. \u1ed0ng thu th\u1eadp n\u1eb1m sau NT tr\u01b0\u1edbc \u0110MC
      6. Xoang v\u00e0nh gi\u00e3n (n\u1ebfu t\u1ea1i tim) ho\u1eb7c TM \u0111i l\u00ean ho\u1eb7c TM \u0111i xu\u1ed1ng.

      Th\u1ec3 tr\u00ean c\u01a1 ho\u00e0nh th\u01b0\u1eddng l\u00e0m t\u0103ng l\u01b0\u1ee3ng m\u00e1u v\u1ec1 tim ph\u1ea3i g\u00e2y m\u1ea5t c\u00e2n \u0111\u1ed1i th\u1ea5t v\u00e0 \u0111\u1ea1i \u0111\u1ed9ng m\u1ea1ch, tim ph\u1ea3i l\u1edbn h\u01a1n tim tr\u00e1i.

      Th\u1ec3 d\u01b0\u1edbi c\u01a1 ho\u00e0nh c\u00f3 th\u1ec3 kh\u00f4ng l\u00e0m t\u0103ng l\u01b0u l\u01b0\u1ee3ng m\u00e1u v\u1ec1 tim ph\u1ea3i v\u00ec ph\u1ea7n l\u1edbn m\u00e1u v\u1ec1 TMC d\u01b0\u1edbi qua l\u1ed7 b\u1ea7u d\u1ee5c v\u00e0 v\u1ec1 nh\u0129 tr\u00e1i.       \u21a9\ufe0e<\/a><\/li><\/ol>","protected":false},"excerpt":{"rendered":"

      T\u1ed3n t\u1ea1i t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean tr\u00e1i k\u00e8m kh\u00f4ng c\u00f3 t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean ph\u1ea3i.<\/p>\n","protected":false},"author":1,"featured_media":1067,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":"[{\"content\":\"Mang thai l\u1ea7n \u0111\u1ea7u, ch\u01b0a sinh l\u1ea7n n\u00e0o\",\"id\":\"a7e44ff6-a0e0-4f67-b55a-74de342c3276\"},{\"content\":\"T\u1ed3n t\u1ea1i t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean b\u00ean tr\u00e1i k\u00e8m kh\u00f4ng c\u00f3 t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean b\u00ean ph\u1ea3i\",\"id\":\"f9ef7dba-0176-4b09-a4a8-4721e9f3cf82\"},{\"content\":\"C\u00f3 4 th\u1ec3 TAPVC: type I: tr\u00ean tim (hay g\u1eb7p nh\u1ea5t), type II: t\u1ea1i tim, type III: d\u01b0\u1edbi tim, type IV: h\u1ed7n h\u1ee3p.
      Type I<\/strong>: tr\u00ean tim hay g\u1eb7p nh\u1ea5t. TMP n\u1ed1i v\u1edbi \u1ed1ng g\u00f3p ph\u00eda sau nh\u0129 tr\u00e1i, theo TM \u0111\u1ee9ng d\u1ecdc n\u1ed1i v\u1edbi TM v\u00f4 danh.
      Type II<\/strong>: t\u1ea1i tim. TM ph\u1ed5i n\u1ed1i v\u1edbi xoang v\u00e0nh d\u00e3n ho\u1eb7c tr\u1ef1c ti\u1ebfp th\u00e0nh sau nh\u0129 ph\u1ea3i.
      Type III<\/strong>: d\u01b0\u1edbi tim. TMP n\u1ed1i v\u1edbi TM \u0111\u1ee9ng d\u1ecdc xuy\u00ean qua c\u01a1 ho\u00e0nh k\u1ebft n\u1ed1i v\u1edbi TM gan. Th\u1ec3 n\u00e0y nguy hi\u1ec3m v\u00ec c\u00f3 th\u1ec3 b\u1ecb ch\u00e8n \u00e9p.

      C\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a b\u1ea5t th\u01b0\u1eddng h\u1ed3i l\u01b0u TMP to\u00e0n ph\u1ea7n (Total Anomalous Pumonary Venous Connections - TAPVC)
      1. Kh\u00f4ng th\u1ea5y d\u00f2ng ch\u1ea3y c\u1ee7a TMP v\u00e0o NT
      2. Nh\u0129 tr\u00e1i nh\u1ecf
      3. Tim ph\u1ea3i > tim tr\u00e1i
      4. \u0110MP > \u0110MC
      5. \u1ed0ng thu th\u1eadp n\u1eb1m sau NT tr\u01b0\u1edbc \u0110MC
      6. Xoang v\u00e0nh gi\u00e3n (n\u1ebfu t\u1ea1i tim) ho\u1eb7c TM \u0111i l\u00ean ho\u1eb7c TM \u0111i xu\u1ed1ng.

      Th\u1ec3 tr\u00ean c\u01a1 ho\u00e0nh th\u01b0\u1eddng l\u00e0m t\u0103ng l\u01b0\u1ee3ng m\u00e1u v\u1ec1 tim ph\u1ea3i g\u00e2y m\u1ea5t c\u00e2n \u0111\u1ed1i th\u1ea5t v\u00e0 \u0111\u1ea1i \u0111\u1ed9ng m\u1ea1ch, tim ph\u1ea3i l\u1edbn h\u01a1n tim tr\u00e1i.

      Th\u1ec3 d\u01b0\u1edbi c\u01a1 ho\u00e0nh c\u00f3 th\u1ec3 kh\u00f4ng l\u00e0m t\u0103ng l\u01b0u l\u01b0\u1ee3ng m\u00e1u v\u1ec1 tim ph\u1ea3i v\u00ec ph\u1ea7n l\u1edbn m\u00e1u v\u1ec1 TMC d\u01b0\u1edbi qua l\u1ed7 b\u1ea7u d\u1ee5c v\u00e0 v\u1ec1 nh\u0129 tr\u00e1i.\",\"id\":\"e2ad5fe6-0397-4c62-b99a-5d1bc8ed0191\"}]"},"categories":[1,78],"tags":[82,81,83,80,79],"class_list":["post-1053","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-khong-phan-loai","category-the-fetus-net","tag-lsvc","tag-plsvc","tag-tapvc","tag-the-fetus","tag-tim-thai"],"_links":{"self":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts\/1053","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/comments?post=1053"}],"version-history":[{"count":12,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts\/1053\/revisions"}],"predecessor-version":[{"id":1068,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/posts\/1053\/revisions\/1068"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/media\/1067"}],"wp:attachment":[{"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/media?parent=1053"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/categories?post=1053"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cdha.edu.vn\/cdha\/wp-json\/wp\/v2\/tags?post=1053"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}