{"id":3587,"date":"2014-08-28T20:58:07","date_gmt":"2014-08-28T20:58:07","guid":{"rendered":"https:\/\/lpfch.org\/obstetrics-raising-the-bar\/"},"modified":"2024-10-23T17:02:33","modified_gmt":"2024-10-23T17:02:33","slug":"obstetrics-raising-the-bar","status":"publish","type":"post","link":"https:\/\/lpfch.org\/vi\/impact-stories\/obstetrics-raising-the-bar\/","title":{"rendered":"S\u1ea3n khoa: N\u00e2ng cao ti\u00eau chu\u1ea9n"},"content":{"rendered":"

M\u1ed9t th\u1ebf k\u1ef7 tr\u01b0\u1edbc, vi\u1ec7c sinh n\u1edf \u1edf Hoa K\u1ef3 kh\u00f4ng h\u1ec1 \u0111\u01a1n gi\u1ea3n. Trung b\u00ecnh, c\u1ee9 1.000 ca sinh n\u1edf, c\u00f3 8 ph\u1ee5 n\u1eef t\u1eed vong do bi\u1ebfn ch\u1ee9ng thai k\u1ef3.<\/p>\n

Ng\u00e0y nay t\u1ea1i Hoa K\u1ef3, c\u1ee9 100.000 ca sinh th\u00ec c\u00f3 ch\u01b0a \u0111\u1ebfn 20 ph\u1ee5 n\u1eef t\u1eed vong - m\u1ed9t s\u1ef1 thay \u0111\u1ed5i \u0111\u00e1ng k\u1ec3 ph\u1ea7n l\u1edbn l\u00e0 nh\u1edd nh\u1eefng c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3 v\u1ec1 s\u1ee9c kh\u1ecfe c\u1ed9ng \u0111\u1ed3ng v\u00e0 nh\u1eefng ti\u1ebfn b\u1ed9 v\u01b0\u1ee3t b\u1eadc trong y h\u1ecdc s\u1ea3n khoa.<\/p>\n

Tr\u01b0\u1eddng Y Stanford tuy\u1ec3n d\u1ee5ng gi\u00e1o s\u01b0 s\u1ea3n khoa \u0111\u1ea7u ti\u00ean v\u00e0o n\u0103m 1912, v\u00e0 trong th\u1ebf k\u1ef7 k\u1ec3 t\u1eeb \u0111\u00f3 \u0111\u00e3 \u0111i \u0111\u1ea7u trong vi\u1ec7c c\u1ea3i thi\u1ec7n cu\u1ed9c s\u1ed1ng c\u1ee7a c\u00e1c b\u00e0 m\u1eb9 t\u01b0\u01a1ng lai v\u00e0 tr\u1ebb s\u01a1 sinh. V\u1edbi vi\u1ec7c b\u1ed5 sung B\u1ec7nh vi\u1ec7n Nhi \u0111\u1ed3ng Lucile Packard v\u00e0o n\u0103m 1991, Stanford nhanh ch\u00f3ng tr\u1edf th\u00e0nh \u0111\u01a1n v\u1ecb d\u1eabn \u0111\u1ea7u \u0111\u01b0\u1ee3c c\u00f4ng nh\u1eadn tr\u00ean to\u00e0n qu\u1ed1c v\u1ec1 nghi\u00ean c\u1ee9u v\u00e0 \u0111\u00e0o t\u1ea1o s\u1ea3n khoa.<\/p>\n

Ti\u1ebfn s\u0129 Maurice Druzin, Gi\u00e1o s\u01b0 Charles B. v\u00e0 Ann L. Johnson ki\u00eam ph\u00f3 ch\u1ee7 t\u1ecbch khoa s\u1ea3n ph\u1ee5 khoa cho bi\u1ebft: "Ch\u1ec9 trong v\u00f2ng 20 n\u0103m, c\u00e1c nh\u00e0 nghi\u00ean c\u1ee9u c\u1ee7a Packard \u0111\u00e3 th\u1ef1c s\u1ef1 thay \u0111\u1ed5i ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb chuy\u1ec3n d\u1ea1 sinh non \u1edf \u0111\u1ea5t n\u01b0\u1edbc n\u00e0y".<\/p>\n

Druzin gia nh\u1eadp khoa v\u00e0o th\u00e1ng 7 n\u0103m 1991, ngay sau khi B\u1ec7nh vi\u1ec7n Nhi Packard m\u1edf c\u1eeda. Trong s\u1ed1 \u00edt b\u00e1c s\u0129 n\u1ed9i tr\u00fa s\u1ea3n khoa t\u1ea1i B\u1ec7nh vi\u1ec7n m\u1edbi c\u00f3 Ti\u1ebfn s\u0129 Y khoa Yasser El-Sayed, hi\u1ec7n l\u00e0 gi\u00e1o s\u01b0 s\u1ea3n ph\u1ee5 khoa v\u00e0 ph\u00f3 khoa y h\u1ecdc b\u00e0 m\u1eb9 v\u00e0 thai nhi.<\/p>\n

\u201cChuy\u00ean m\u00f4n s\u00e2u r\u1ed9ng c\u1ee7a Packard \u0111\u00e3 thu h\u00fat nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 r\u1ea5t cao t\u1eeb kh\u1eafp c\u1ea3 n\u01b0\u1edbc\u201d, El-Sayed nh\u1edb l\u1ea1i. \u201c\u0110i\u1ec1u \u0111\u00f3 r\u1ea5t quan tr\u1ecdng, v\u00ec n\u00f3 \u0111\u00e3 t\u1ea1o ra m\u1ed9t c\u1ed9ng \u0111\u1ed3ng \u0111\u1ee7 l\u1edbn \u0111\u1ec3 ch\u00fang t\u00f4i ph\u00e1t tri\u1ec3n c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng v\u1ec1 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb v\u00e0 quy tr\u00ecnh m\u1edbi.\u201d<\/p>\n

Ng\u00e0y nay, c\u00e1c chuy\u00ean gia s\u1ea3n khoa t\u1ea1i B\u1ec7nh vi\u1ec7n Nhi Packard v\u1eabn t\u00edch c\u1ef1c tham gia nghi\u00ean c\u1ee9u li\u00ean ng\u00e0nh \u0111\u1ec3 ph\u00e1t tri\u1ec3n c\u00e1c quy tr\u00ecnh v\u00e0 chi\u1ebfn l\u01b0\u1ee3c m\u1edbi nh\u1eb1m ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb v\u00e0 ph\u00f2ng ng\u1eeba c\u00e1c v\u1ea5n \u0111\u1ec1 sinh s\u1ea3n v\u00e0 s\u01a1 sinh. C\u00e1c chuy\u00ean gia tr\u00ean kh\u1eafp B\u1ec7nh vi\u1ec7n v\u00e0 khu y t\u1ebf \u0111ang t\u1eadp trung v\u00e0o vi\u1ec7c c\u1ea3i ti\u1ebfn thu\u1ed1c men v\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb chuy\u1ec3n d\u1ea1 sinh non, \u0111\u1ed3ng th\u1eddi theo \u0111u\u1ed5i c\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 b\u1ed9 gen c\u00f3 th\u1ec3 gi\u00fap x\u00e1c \u0111\u1ecbnh c\u00e1c t\u00ecnh tr\u1ea1ng ho\u1eb7c v\u1ea5n \u0111\u1ec1 nguy c\u01a1 trong qu\u00e1 tr\u00ecnh ph\u00e1t tri\u1ec3n c\u1ee7a thai nhi.<\/p>\n

\u201cCh\u00fang t\u00f4i \u0111\u00e3 x\u00e2y d\u1ef1ng \u0111\u01b0\u1ee3c th\u00e0nh t\u00edch xu\u1ea5t s\u1eafc trong nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng v\u00e0 y h\u1ecdc chuy\u1ec3n d\u1ecbch\u201d, El-Sayed n\u00f3i. \u201cNghi\u00ean c\u1ee9u l\u00e0 m\u1ed9t ph\u1ea7n quan tr\u1ecdng trong cam k\u1ebft c\u1ee7a ch\u00fang t\u00f4i v\u00e0 gi\u00fap Packard m\u1edf r\u1ed9ng d\u1ecbch v\u1ee5 ch\u0103m s\u00f3c l\u00e2m s\u00e0ng v\u00e0 ti\u1ebfp c\u1eadn c\u1ed9ng \u0111\u1ed3ng.\u201d<\/p>\n

Nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng s\u00e1ng t\u1ea1o<\/h2>\n

B\u1ed1n n\u0103m tr\u01b0\u1edbc, Ti\u1ebfn s\u0129 El-Sayed v\u00e0 Ph\u00f3 Gi\u00e1o s\u01b0 S\u1ea3n ph\u1ee5 khoa Deirdre Lyell \u0111\u00e3 b\u1eaft \u0111\u1ea7u th\u1eed nghi\u1ec7m thu\u1ed1c nifedipine, m\u1ed9t lo\u1ea1i thu\u1ed1c gi\u00e3n c\u01a1 th\u01b0\u1eddng \u0111\u01b0\u1ee3c d\u00f9ng cho ph\u1ee5 n\u1eef mang thai trong giai \u0111o\u1ea1n \u0111\u1ea7u chuy\u1ec3n d\u1ea1 \u0111\u1ec3 gi\u1ea3m c\u00e1c c\u01a1n co th\u1eaft v\u00e0 ng\u0103n ng\u1eeba sinh non. M\u1eb7c d\u00f9 \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n r\u1ed9ng r\u00e3i, nifedipine ch\u01b0a bao gi\u1edd \u0111\u01b0\u1ee3c th\u1eed nghi\u1ec7m trong m\u1ed9t nghi\u00ean c\u1ee9u c\u00f3 \u0111\u1ed1i ch\u1ee9ng gi\u1ea3 d\u01b0\u1ee3c.<\/p>\n

N\u0103m 2008, Lyell v\u00e0 c\u00e1c \u0111\u1ed3ng nghi\u1ec7p \u0111\u00e3 tuy\u1ec3n d\u1ee5ng 70 ph\u1ee5 n\u1eef t\u1ea1i B\u1ec7nh vi\u1ec7n Nhi Packard \u0111ang trong giai \u0111o\u1ea1n chuy\u1ec3n d\u1ea1 s\u1edbm. M\u1ed9t s\u1ed1 \u0111\u01b0\u1ee3c cho d\u00f9ng ng\u1eabu nhi\u00ean nifedipine, s\u1ed1 kh\u00e1c \u0111\u01b0\u1ee3c cho u\u1ed1ng vi\u00ean \u0111\u01b0\u1eddng.<\/p>\n

Lyell, t\u00e1c gi\u1ea3 ch\u00ednh c\u1ee7a nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c H\u1ecdc vi\u1ec7n S\u1ea3n ph\u1ee5 khoa Hoa K\u1ef3 vinh danh l\u00e0 m\u1ed9t trong nh\u1eefng b\u00e0i b\u00e1o nghi\u00ean c\u1ee9u xu\u1ea5t s\u1eafc nh\u1ea5t n\u0103m 2008, cho bi\u1ebft: "Ch\u00fang t\u00f4i th\u1ea5y r\u1eb1ng nifedipine kh\u00f4ng hi\u1ec7u qu\u1ea3 h\u01a1n gi\u1ea3 d\u01b0\u1ee3c trong vi\u1ec7c tr\u00ec ho\u00e3n vi\u1ec7c sinh n\u1edf".<\/p>\n

"Ch\u00fang t\u00f4i \u0111\u00e3 ch\u1ee9ng minh r\u1eb1ng ph\u1ee5 n\u1eef mang thai \u0111ang ti\u1ebfp x\u00fac v\u1edbi nhi\u1ec1u lo\u1ea1i thu\u1ed1c m\u1ed9t c\u00e1ch kh\u00f4ng c\u1ea7n thi\u1ebft", El-Sayed n\u00f3i th\u00eam. "T\u00f4i tin t\u01b0\u1edfng r\u1eb1ng th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng c\u1ee7a ch\u00fang t\u00f4i \u0111\u00e3 t\u1ea1o ra m\u1ed9t thay \u0111\u1ed5i l\u1edbn trong c\u00e1ch s\u1eed d\u1ee5ng nifedipine \u1edf qu\u1ed1c gia n\u00e0y."<\/p>\n

N\u0103m 2010, Lyell \u0111\u01b0\u1ee3c b\u1ed5 nhi\u1ec7m l\u00e0m gi\u00e1m \u0111\u1ed1c m\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh m\u1edbi t\u1ea1i B\u1ec7nh vi\u1ec7n Nhi Packard, \u0111\u01b0\u1ee3c th\u00e0nh l\u1eadp \u0111\u1ec3 nghi\u00ean c\u1ee9u c\u00e1c r\u1ed1i lo\u1ea1n nhau thai v\u00e0 \u0111\u01a1n gi\u1ea3n h\u00f3a vi\u1ec7c ch\u0103m s\u00f3c ph\u1ee5 n\u1eef mang thai c\u00f3 nhau thai b\u00e1m b\u1ea5t th\u01b0\u1eddng.<\/p>\n

"Th\u00f4ng th\u01b0\u1eddng nhau thai s\u1ebd t\u1ef1 bong ra kh\u1ecfi t\u1eed cung sau khi sinh, nh\u01b0ng khi nhau thai kh\u00f4ng bong ra, nguy c\u01a1 \u0111\u1ed1i v\u1edbi ng\u01b0\u1eddi ph\u1ee5 n\u1eef s\u1ebd t\u0103ng l\u00ean \u0111\u00e1ng k\u1ec3", b\u00e1c s\u0129 Lyell gi\u1ea3i th\u00edch. V\u00ed d\u1ee5, m\u1ed9t t\u1ef7 l\u1ec7 nh\u1ecf ph\u1ee5 n\u1eef mang thai \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n m\u1eafc ch\u1ee9ng nhau c\u00e0i r\u0103ng l\u01b0\u1ee3c, m\u1ed9t t\u00ecnh tr\u1ea1ng nhau thai ph\u00e1t tri\u1ec3n qu\u00e1 s\u00e2u v\u00e0o th\u00e0nh t\u1eed cung. Nhau c\u00e0i r\u0103ng l\u01b0\u1ee3c c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ch\u1ea3y m\u00e1u \u00e2m \u0111\u1ea1o v\u00e0 sinh non, v\u00e0 l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y t\u1eed vong cho ph\u1ee5 n\u1eef trong khi sinh. Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng bao g\u1ed3m c\u1eaft b\u1ecf t\u1eed cung sau sinh.<\/p>\n

Nghi\u00ean c\u1ee9u cho th\u1ea5y sinh m\u1ed5 l\u00e0m t\u0103ng \u0111\u00e1ng k\u1ec3 nguy c\u01a1 nhau c\u00e0i r\u0103ng l\u01b0\u1ee3c. M\u1ed9t ph\u1ee5 n\u1eef \u0111\u00e3 t\u1eebng sinh m\u1ed5 v\u00e0 m\u1ed9t l\u1ea7n c\u00f3 nguy c\u01a1 b\u1ecb nhau c\u00e0i r\u0103ng l\u01b0\u1ee3c trong l\u1ea7n mang thai ti\u1ebfp theo l\u00ean t\u1edbi 25%.<\/p>\n

Lyell cho bi\u1ebft: "Do s\u1ed1 ca sinh m\u1ed5 t\u0103ng tr\u00ean to\u00e0n qu\u1ed1c, hi\u1ec7n nay t\u1ef7 l\u1ec7 nhau c\u00e0i r\u0103ng l\u01b0\u1ee3c \u1edf Hoa K\u1ef3 c\u0169ng cao h\u01a1n. Ch\u00fang t\u00f4i \u0111ang ti\u1ebfn h\u00e0nh nghi\u00ean c\u1ee9u l\u00fd do t\u1ea1i sao ph\u1ee5 n\u1eef \u0111\u00e3 sinh m\u1ed5 d\u1ec5 b\u1ecb r\u1ed1i lo\u1ea1n nhau thai h\u01a1n, v\u00e0 \u0111ang n\u1ed7 l\u1ef1c t\u00ecm ra c\u00e1c k\u1ef9 thu\u1eadt ph\u1eabu thu\u1eadt trong qu\u00e1 tr\u00ecnh sinh m\u1ed5 c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m nguy c\u01a1 nhau c\u00e0i r\u0103ng l\u01b0\u1ee3c trong t\u01b0\u01a1ng lai." Lyell g\u1ea7n \u0111\u00e2y \u0111\u00e3 \u0111\u01b0\u1ee3c trao Gi\u1ea3i th\u01b0\u1edfng H\u1ecdc gi\u1ea3 Khoa Harman danh gi\u00e1 \u0111\u1ec3 ti\u1ebfp t\u1ee5c nghi\u00ean c\u1ee9u v\u1ec1 t\u00ecnh tr\u1ea1ng nhau c\u00e0i r\u0103ng l\u01b0\u1ee3c.<\/p>\n

Tr\u1ea7m c\u1ea3m trong thai k\u1ef3 l\u00e0 m\u1ed9t tr\u1ecdng t\u00e2m nghi\u00ean c\u1ee9u kh\u00e1c c\u1ee7a Lyell. "C\u1ea7n ph\u1ea3i c\u00f3 ch\u01b0\u01a1ng tr\u00ecnh s\u00e0ng l\u1ecdc tr\u1ea7m c\u1ea3m to\u00e0n di\u1ec7n cho ph\u1ee5 n\u1eef mang thai", b\u00e0 n\u00f3i. "Trong nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p, t\u00ecnh tr\u1ea1ng n\u00e0y th\u1eadm ch\u00ed c\u00f2n kh\u00f4ng \u0111\u01b0\u1ee3c ghi nh\u1eadn trong h\u1ed3 s\u01a1 b\u1ec7nh \u00e1n c\u1ee7a h\u1ecd."<\/p>\n

V\u00ec c\u00e1c b\u00e0 m\u1eb9 t\u01b0\u01a1ng lai th\u01b0\u1eddng ng\u1ea1i d\u00f9ng thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m n\u00ean Lyell v\u00e0 c\u00e1c \u0111\u1ed3ng nghi\u1ec7p c\u1ee7a b\u00e0 \u0111\u00e3 ti\u1ebfn h\u00e0nh th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb thay th\u1ebf.<\/p>\n

N\u0103m 2010, b\u00e0 v\u00e0 Druzin \u0111\u1ed3ng s\u00e1ng t\u00e1c m\u1ed9t nghi\u00ean c\u1ee9u do Ti\u1ebfn s\u0129 Rachel Manber, gi\u00e1o s\u01b0 t\u00e2m th\u1ea7n h\u1ecdc d\u1eabn \u0111\u1ea7u, cho th\u1ea5y ch\u00e2m c\u1ee9u c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p thay th\u1ebf kh\u1ea3 thi cho ph\u1ee5 n\u1eef mang thai b\u1ecb tr\u1ea7m c\u1ea3m.
\nNghi\u00ean c\u1ee9u di truy\u1ec1n h\u1ee3p t\u00e1c<\/p>\n

C\u00e1c nh\u00e0 nghi\u00ean c\u1ee9u t\u1ea1i Stanford c\u0169ng \u0111ang n\u1ed7 l\u1ef1c gi\u1ea3i quy\u1ebft c\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng c\u1ee7a thai k\u1ef3 b\u1eb1ng c\u00e1c k\u1ef9 thu\u1eadt ti\u00ean ti\u1ebfn, ch\u1eb3ng h\u1ea1n nh\u01b0 di truy\u1ec1n y h\u1ecdc.<\/p>\n

Ti\u1ebfn s\u0129, B\u00e1c s\u0129 Anna Penn, Ph\u00f3 gi\u00e1o s\u01b0 nhi khoa, l\u00e0 ng\u01b0\u1eddi \u0111\u1ee9ng \u0111\u1ea7u Nh\u00f3m C\u00f4ng t\u00e1c Nhau thai Stanford, m\u1ed9t nh\u00f3m \u0111a ng\u00e0nh g\u1ed3m c\u00e1c nh\u00e0 khoa h\u1ecdc v\u00e0 b\u00e1c s\u0129 t\u1eadp trung v\u00e0o vi\u1ec7c t\u00ecm hi\u1ec3u s\u1ef1 \u0111\u00f3ng g\u00f3p c\u1ee7a b\u1ec7nh l\u00fd nhau thai v\u00e0o t\u00ecnh tr\u1ea1ng sinh non. V\u00ed d\u1ee5, kho\u1ea3ng m\u1ed9t n\u1eeda s\u1ed1 ca sinh non t\u1ea1i B\u1ec7nh vi\u1ec7n Packard m\u1ed7i n\u0103m l\u00e0 do ti\u1ec1n s\u1ea3n gi\u1eadt, m\u1ed9t t\u00ecnh tr\u1ea1ng g\u00e2y ra huy\u1ebft \u00e1p cao \u1edf ph\u1ee5 n\u1eef mang thai. Ti\u1ec1n s\u1ea3n gi\u1eadt n\u1eb7ng c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn co gi\u1eadt v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe nghi\u00eam tr\u1ecdng kh\u00e1c cho ng\u01b0\u1eddi m\u1eb9. M\u1ed9t m\u1ee5c ti\u00eau c\u1ee7a Nh\u00f3m C\u00f4ng t\u00e1c Nhau thai l\u00e0 l\u00e0m s\u00e1ng t\u1ecf r\u1ed1i lo\u1ea1n n\u00e0y b\u1eb1ng c\u00e1ch so s\u00e1nh c\u00e1c m\u1eabu DNA t\u1eeb h\u00e0ng tr\u0103m nhau thai \u0111\u01b0\u1ee3c hi\u1ebfn t\u1eb7ng b\u1edfi c\u00e1c b\u1ec7nh nh\u00e2n b\u00ecnh th\u01b0\u1eddng, sinh non v\u00e0 ti\u1ec1n s\u1ea3n gi\u1eadt t\u1ea1i B\u1ec7nh vi\u1ec7n Nhi Packard.<\/p>\n

Nh\u1eefng kho\u1ea3n quy\u00ean g\u00f3p n\u00e0y s\u1ebd h\u00ecnh th\u00e0nh n\u1ec1n t\u1ea3ng cho Ng\u00e2n h\u00e0ng m\u00f4 nhau thai c\u00f3 th\u1ec3 h\u1ed7 tr\u1ee3 nhi\u1ec1u h\u01b0\u1edbng nghi\u00ean c\u1ee9u t\u1ea1i Stanford.<\/p>\n

Trong khi \u0111\u00f3, Ti\u1ebfn s\u0129, B\u00e1c s\u0129 Y khoa Nihar Nayak, ph\u00f3 gi\u00e1o s\u01b0 s\u1ea3n ph\u1ee5 khoa, \u0111ang ti\u1ebfn h\u00e0nh nghi\u00ean c\u1ee9u c\u01a1 b\u1ea3n v\u00e0 chuy\u1ec3n d\u1ecbch v\u1ec1 t\u00ecnh tr\u1ea1ng nhau thai b\u1ea5t th\u01b0\u1eddng d\u1eabn \u0111\u1ebfn c\u00e1c b\u1ec7nh l\u00fd kh\u00e1c nhau trong thai k\u1ef3, \u0111\u1eb7c bi\u1ec7t l\u00e0 ti\u1ec1n s\u1ea3n gi\u1eadt. Nayak nghi\u00ean c\u1ee9u c\u00e1c y\u1ebfu t\u1ed1 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn qu\u00e1 tr\u00ecnh h\u00ecnh th\u00e0nh m\u1ea1ch m\u00e1u, qu\u00e1 tr\u00ecnh t\u1ea1o ra c\u00e1c m\u1ea1ch m\u00e1u m\u1edbi, m\u1ed9t b\u01b0\u1edbc quan tr\u1ecdng cho s\u1ef1 ph\u00e1t tri\u1ec3n b\u00ecnh th\u01b0\u1eddng c\u1ee7a nhau thai. G\u1ea7n \u0111\u00e2y, Druzin, El-Sayed, Nayak v\u00e0 c\u00e1c c\u1ed9ng s\u1ef1 t\u1ea1i Khoa Y \u0111\u00e3 \u0111\u1ed3ng t\u00e1c gi\u1ea3 m\u1ed9t nghi\u00ean c\u1ee9u x\u00e1c \u0111\u1ecbnh m\u1ed9t d\u1ea5u \u1ea5n sinh h\u1ecdc m\u1edbi ti\u1ec1m n\u0103ng \u0111\u1ec3 s\u00e0ng l\u1ecdc ti\u1ec1n s\u1ea3n gi\u1eadt.<\/p>\n

Nayak v\u00e0 nh\u00f3m nghi\u00ean c\u1ee9u c\u1ee7a \u00f4ng c\u0169ng \u0111\u00e3 ph\u00e1t tri\u1ec3n m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p m\u1edbi \u0111\u1ec3 theo d\u00f5i bi\u1ec3u hi\u1ec7n gen nhau thai trong su\u1ed1t thai k\u1ef3, m\u1ed9t b\u01b0\u1edbc ti\u1ebfn \u0111\u00e1ng k\u1ec3 cho c\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 ch\u1ee9c n\u0103ng c\u1ee7a gen nhau thai.<\/p>\n

Trong m\u1ed9t nghi\u00ean c\u1ee9u kh\u00e1c, El-Sayed, Lyell v\u00e0 Druzin g\u1ea7n \u0111\u00e2y \u0111\u00e3 \u0111\u1ed3ng t\u00e1c gi\u1ea3 m\u1ed9t nghi\u00ean c\u1ee9u so s\u00e1nh k\u1ebft qu\u1ea3 thai k\u1ef3 gi\u1eefa c\u00e1c c\u1eb7p v\u1ee3 ch\u1ed3ng da tr\u1eafng v\u00e0 da \u0111en\/da tr\u1eafng. Nghi\u00ean c\u1ee9u, d\u1ef1a tr\u00ean d\u1eef li\u1ec7u thu th\u1eadp t\u1eeb h\u01a1n 9.000 c\u1eb7p v\u1ee3 ch\u1ed3ng sinh con t\u1ea1i B\u1ec7nh vi\u1ec7n Nhi Packard t\u1eeb n\u0103m 2000 \u0111\u1ebfn n\u0103m 2006, cho th\u1ea5y ph\u1ee5 n\u1eef mang thai c\u00f3 nguy c\u01a1 m\u1eafc b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng thai k\u1ef3 cao h\u01a1n n\u1ebfu m\u1ed9t trong hai cha m\u1eb9 l\u00e0 ng\u01b0\u1eddi ch\u00e2u \u00c1 v\u00e0 ng\u01b0\u1eddi kia l\u00e0 ng\u01b0\u1eddi da tr\u1eafng. Druzin cho bi\u1ebft: "V\u1edbi s\u1ef1 \u0111a d\u1ea1ng phong ph\u00fa c\u1ee7a Khu v\u1ef1c V\u1ecbnh San Francisco, \u0111\u00e2y l\u00e0 m\u1ed9t \u0111\u00f3ng g\u00f3p quan tr\u1ecdng cho s\u1ef1 hi\u1ec3u bi\u1ebft c\u1ee7a ch\u00fang ta v\u1ec1 vai tr\u00f2 c\u1ee7a s\u1eafc t\u1ed9c \u0111\u1ed1i v\u1edbi k\u1ebft qu\u1ea3 thai k\u1ef3".<\/p>\n

B\u00ean kia khu\u00f4n vi\u00ean tr\u01b0\u1eddng, Ti\u1ebfn s\u0129 Stephen Quake, gi\u00e1o s\u01b0 k\u1ef9 thu\u1eadt sinh h\u1ecdc v\u00e0 v\u1eadt l\u00fd, \u0111\u00e3 ph\u00e1t tri\u1ec3n m\u1ed9t x\u00e9t nghi\u1ec7m ti\u1ec1n s\u1ea3n kh\u00f4ng x\u00e2m l\u1ea5n \u0111\u1ec3 ph\u00e1t hi\u1ec7n h\u1ed9i ch\u1ee9ng Down v\u00e0 c\u00e1c r\u1ed1i lo\u1ea1n di truy\u1ec1n kh\u00e1c. C\u00e1c th\u1ee7 thu\u1eadt s\u00e0ng l\u1ecdc ti\u00eau chu\u1ea9n, ch\u1eb3ng h\u1ea1n nh\u01b0 ch\u1ecdc \u1ed1i, r\u1ea5t nguy hi\u1ec3m v\u00ec c\u1ea7n ph\u1ea3i \u0111\u01b0a kim v\u00e0o t\u1eed cung \u0111\u1ec3 l\u1ea5y m\u1eabu DNA nhau thai. K\u1ef9 thu\u1eadt c\u1ee7a Quake ph\u00e2n l\u1eadp DNA thai nhi trong m\u00e1u m\u1eb9, lo\u1ea1i b\u1ecf nhu c\u1ea7u ch\u1ecdc nhau thai v\u00e0 do \u0111\u00f3 gi\u1ea3m thi\u1ec3u nguy c\u01a1 s\u1ea3y thai.<\/p>\n

"M\u1ecdi ng\u01b0\u1eddi \u0111\u00f4i khi lo s\u1ee3 v\u1ec1 x\u00e9t nghi\u1ec7m di truy\u1ec1n", Ti\u1ebfn s\u0129 Mary Norton, gi\u00e1o s\u01b0 s\u1ea3n ph\u1ee5 khoa v\u00e0 nhi khoa, cho bi\u1ebft. L\u00e0 m\u1ed9t chuy\u00ean gia v\u1ec1 di truy\u1ec1n m\u1eb9-thai, Norton \u0111\u01b0\u1ee3c tuy\u1ec3n d\u1ee5ng v\u00e0o B\u1ec7nh vi\u1ec7n Nhi Packard n\u0103m 2008 v\u1edbi v\u1ecb tr\u00ed gi\u00e1m \u0111\u1ed1c nghi\u00ean c\u1ee9u chu sinh.<\/p>\n

Norton cho bi\u1ebft: "Trong c\u00e1c nghi\u00ean c\u1ee9u c\u1ee7a ch\u00fang t\u00f4i, ch\u00fang t\u00f4i nh\u1eadn th\u1ea5y r\u1eb1ng v\u1edbi c\u00e1c th\u1ee7 thu\u1eadt x\u00e2m l\u1ea5n, ch\u1eb3ng h\u1ea1n nh\u01b0 ch\u1ecdc \u1ed1i, ph\u1ee5 n\u1eef mang thai c\u00f3 xu h\u01b0\u1edbng ch\u1ecdn l\u1ecdc h\u01a1n. H\u1ecd ch\u1ec9 mu\u1ed1n \u0111\u01b0\u1ee3c x\u00e9t nghi\u1ec7m c\u00e1c b\u1ec7nh nghi\u00eam tr\u1ecdng ho\u1eb7c c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y t\u1eed vong."<\/p>\n

Ch\u0103m s\u00f3c n\u00e2ng cao tr\u00ean to\u00e0n qu\u1ed1c<\/h2>\n

\u0110\u1ec3 m\u1edf r\u1ed9ng c\u01a1 h\u1ed9i nghi\u00ean c\u1ee9u c\u00f3 t\u00e1c \u0111\u1ed9ng cao v\u01b0\u1ee3t ra ngo\u00e0i khu\u00f4n vi\u00ean tr\u01b0\u1eddng y, Norton v\u00e0 c\u00e1c \u0111\u1ed3ng nghi\u1ec7p \u0111\u00e3 n\u1ed9p \u0111\u01a1n thay m\u1eb7t Stanford xin gia nh\u1eadp M\u1ea1ng l\u01b0\u1edbi \u0110\u01a1n v\u1ecb Y h\u1ecdc M\u1eb9 v\u00e0 Thai nhi (MFMU), m\u1ed9t t\u1eadp \u0111o\u00e0n g\u1ed3m 14 trung t\u00e2m l\u00e2m s\u00e0ng t\u1ea1i c\u00e1c tr\u01b0\u1eddng \u0111\u1ea1i h\u1ecdc tr\u00ean kh\u1eafp Hoa K\u1ef3. \u0110\u01b0\u1ee3c th\u00e0nh l\u1eadp v\u00e0o n\u0103m 1986 v\u1edbi t\u01b0 c\u00e1ch l\u00e0 trung t\u00e2m qu\u1ed1c gia v\u1ec1 nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng trong s\u1ea3n khoa, M\u1ea1ng l\u01b0\u1edbi n\u00e0y \u0111i\u1ec1u ph\u1ed1i c\u00e1c th\u1eed nghi\u1ec7m tr\u00ean to\u00e0n qu\u1ed1c v\u00e0 c\u00e1c nghi\u00ean c\u1ee9u d\u00e2n s\u1ed1 quy m\u00f4 l\u1edbn li\u00ean quan \u0111\u1ebfn h\u00e0ng ngh\u00ecn ph\u1ee5 n\u1eef mang thai v\u00e0 tr\u1ebb s\u01a1 sinh tr\u00ean kh\u1eafp c\u1ea3 n\u01b0\u1edbc.<\/p>\n

\u0110\u1ea7u n\u0103m nay, Vi\u1ec7n Y t\u1ebf Qu\u1ed1c gia \u0111\u00e3 ch\u1ea5p thu\u1eadn \u0111\u01a1n \u0111\u0103ng k\u00fd, \u0111\u01b0a Stanford tr\u1edf th\u00e0nh trung t\u00e2m MFMU \u0111\u1ea7u ti\u00ean v\u00e0 duy nh\u1ea5t t\u1ea1i California.<\/p>\n

Ng\u00e0y nay, Norton v\u00e0 El-Sayed \u0111ang d\u1eabn \u0111\u1ea7u hai nghi\u00ean c\u1ee9u c\u1ee7a MFMU, c\u1ea3 hai \u0111\u1ec1u \u0111ang tuy\u1ec3n d\u1ee5ng ph\u1ee5 n\u1eef mang thai tr\u00ean kh\u1eafp Hoa K\u1ef3. M\u1ed9t l\u00e0 th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng c\u00f3 \u0111\u1ed1i ch\u1ee9ng gi\u1ea3 d\u01b0\u1ee3c nh\u1eb1m x\u00e1c \u0111\u1ecbnh xem vi\u1ec7c d\u00f9ng steroid cho nh\u1eefng ph\u1ee5 n\u1eef sinh non c\u00f3 l\u00e0m gi\u1ea3m c\u00e1c bi\u1ebfn ch\u1ee9ng v\u1ec1 h\u00f4 h\u1ea5p \u1edf tr\u1ebb s\u01a1 sinh h\u01a1i non th\u00e1ng hay kh\u00f4ng.<\/p>\n

Nghi\u00ean c\u1ee9u c\u00f2n l\u1ea1i l\u00e0 th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean v\u1ec1 m\u1ed9t thi\u1ebft b\u1ecb ch\u1ea9n \u0111o\u00e1n m\u1edbi g\u1ecdi l\u00e0 ph\u00e2n t\u00edch \u0111o\u1ea1n ST (STAN), li\u00ean t\u1ee5c theo d\u00f5i nh\u1ecbp tim c\u1ee7a thai nhi b\u1eb1ng c\u00f4ng ngh\u1ec7 ti\u00ean ti\u1ebfn h\u01a1n so v\u1edbi ti\u00eau chu\u1ea9n hi\u1ec7n nay. STAN \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng n\u00e3o thai nhi do thi\u1ebfu oxy v\u00e0 cung c\u1ea5p \u0111\u00e1nh gi\u00e1 ch\u00ednh x\u00e1c h\u01a1n v\u1ec1 nh\u1ecbp tim c\u1ee7a em b\u00e9, gi\u00fap gi\u1ea3m thi\u1ec3u c\u00e1c ca m\u1ed5 l\u1ea5y thai kh\u00f4ng c\u1ea7n thi\u1ebft.<\/p>\n

"B\u1ea1n c\u1ea7n c\u00f3 th\u00e0nh t\u00edch \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh trong c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng \u0111\u1ec3 \u0111\u01b0\u1ee3c ch\u1ea5p nh\u1eadn v\u00e0o M\u1ea1ng l\u01b0\u1edbi MFMU", Druzin n\u00f3i. "M\u1ea1ng l\u01b0\u1edbi n\u00e0y r\u1ea5t uy t\u00edn v\u00e0 ph\u1ea3n \u00e1nh cam k\u1ebft c\u1ee7a ch\u00fang t\u00f4i trong vi\u1ec7c th\u00fac \u0111\u1ea9y l\u0129nh v\u1ef1c s\u1ea3n khoa."<\/p>\n

\u0110\u00e0o t\u1ea1o d\u1ef1a tr\u00ean m\u00f4 ph\u1ecfng<\/h2>\n

\u201cS\u1ea3n khoa l\u00e0 m\u1ed9t m\u00f4n th\u1ec3 thao \u0111\u1ed3ng \u0111\u1ed9i\u201d, Ti\u1ebfn s\u0129 Kay Daniels, gi\u00e1o s\u01b0 l\u00e2m s\u00e0ng v\u1ec1 s\u1ea3n ph\u1ee5 khoa, nh\u1eadn x\u00e9t.<\/p>\n

T\u1ea1i B\u1ec7nh vi\u1ec7n Nhi Packard, nh\u00f3m n\u00e0y bao g\u1ed3m c\u00e1c y t\u00e1 chuy\u00ean khoa s\u1ea3n, b\u00e1c s\u0129 nhi khoa s\u01a1 sinh, b\u00e1c s\u0129 s\u1ea3n khoa, b\u00e1c s\u0129 g\u00e2y m\u00ea s\u1ea3n khoa v\u00e0 c\u00e1c chuy\u00ean gia, y t\u00e1 v\u00e0 nh\u00e2n vi\u00ean kh\u00e1c.<\/p>\n

\u0110\u1ec3 gi\u1ea3i quy\u1ebft b\u1ea3n ch\u1ea5t r\u1ee7i ro cao c\u1ee7a y h\u1ecdc s\u1ea3n khoa, Daniels v\u00e0 c\u00e1c \u0111\u1ed3ng nghi\u1ec7p \u0111\u00e3 t\u1ea1o ra m\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh \u0111\u00e0o t\u1ea1o m\u00f4 ph\u1ecfng mang t\u00ean OBSim. Ch\u01b0\u01a1ng tr\u00ecnh ti\u00ean phong n\u00e0y cho ph\u00e9p c\u00e1c b\u00e1c s\u0129, y t\u00e1, b\u00e1c s\u0129 n\u1ed9i tr\u00fa v\u00e0 th\u1ef1c t\u1eadp sinh tr\u1ea3i nghi\u1ec7m nh\u1eefng ca sinh kh\u00f3 trong m\u00f4i tr\u01b0\u1eddng gi\u1ed1ng nh\u01b0 b\u1ec7nh vi\u1ec7n.<\/p>\n

S\u1eed d\u1ee5ng di\u1ec5n vi\u00ean v\u00e0 ma-n\u01a1-canh th\u1eadt, \u0111\u1ed9i ng\u0169 OBSim t\u1ea1o ra c\u00e1c t\u00ecnh hu\u1ed1ng th\u1ef1c t\u1ebf \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 h\u01b0\u1edbng d\u1eabn nh\u00e2n vi\u00ean s\u1ea3n khoa c\u00e1ch x\u1eed l\u00fd c\u00e1c t\u00ecnh hu\u1ed1ng b\u1ea5t ng\u1edd trong ph\u00f2ng sinh c\u00f3 th\u1ec3 \u0111e d\u1ecda \u0111\u1ebfn s\u1ee9c kh\u1ecfe c\u1ee7a b\u00e0 m\u1eb9 v\u00e0 em b\u00e9.<\/p>\n

"Ch\u0103m s\u00f3c s\u1ea3n khoa c\u00f3 m\u1ed9t \u00e1p l\u1ef1c th\u1eddi gian \u0111\u1eb7c th\u00f9", Daniels, \u0111\u1ed3ng gi\u00e1m \u0111\u1ed1c ch\u01b0\u01a1ng tr\u00ecnh OBSim, cho bi\u1ebft. "N\u1ebfu c\u00f3 \u0111i\u1ec1u g\u00ec \u0111\u00f3 th\u1ea3m kh\u1ed1c x\u1ea3y ra, b\u1ea1n ch\u1ec9 c\u00f3 5 ho\u1eb7c 10 ph\u00fat \u0111\u1ec3 x\u1eed l\u00fd. \u0110\u00f3 ch\u00ednh l\u00e0 l\u00fac OBSim h\u1ed7 tr\u1ee3 b\u1eb1ng c\u00e1ch c\u1ea3i thi\u1ec7n giao ti\u1ebfp."<\/p>\n

Ch\u01b0\u01a1ng tr\u00ecnh \u0111\u01b0\u1ee3c tri\u1ec3n khai v\u00e0o n\u0103m 2004, l\u00e0 m\u1ed9t ph\u1ea7n c\u1ee7a Trung t\u00e2m Gi\u00e1o d\u1ee5c Nhi khoa v\u00e0 S\u01a1 sinh Ti\u00ean ti\u1ebfn (CAPE) c\u1ee7a Packard, trung t\u00e2m \u0111\u00e0o t\u1ea1o m\u00f4 ph\u1ecfng \u0111\u1ea7u ti\u00ean tr\u00ean th\u1ebf gi\u1edbi chuy\u00ean \u0111\u00e0o t\u1ea1o c\u00e1c chuy\u00ean gia y t\u1ebf v\u1ec1 ch\u0103m s\u00f3c thai nhi, tr\u1ebb s\u01a1 sinh v\u00e0 s\u1ea3n khoa. "M\u1ed9t m\u00f3n qu\u00e0 t\u1eeb m\u1ed9t nh\u00e0 t\u00e0i tr\u1ee3 \u1ea9n danh \u0111\u00e3 cho ph\u00e9p ch\u00fang t\u00f4i x\u00e2y d\u1ef1ng m\u1ed9t trung t\u00e2m \u0111\u00e0o t\u1ea1o m\u00f4 ph\u1ecfng ngay \u0111\u1ed1i di\u1ec7n B\u1ec7nh vi\u1ec7n Nhi Packard", gi\u00e1m \u0111\u1ed1c CAPE, Ti\u1ebfn s\u0129 Lou Halamek, ph\u00f3 gi\u00e1o s\u01b0 nhi khoa v\u00e0 s\u1ea3n ph\u1ee5 khoa, cho bi\u1ebft.<\/p>\n

Ph\u00f2ng m\u00f4 ph\u1ecfng r\u1ed9ng 37 m\u00e9t vu\u00f4ng (400 feet vu\u00f4ng) \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 m\u00f4 ph\u1ecfng nhi\u1ec1u b\u1ed1i c\u1ea3nh b\u1ec7nh vi\u1ec7n kh\u00e1c nhau. V\u1edbi OBSim, m\u1ed9t gi\u01b0\u1eddng b\u1ec7nh, m\u00e0n h\u00ecnh v\u00e0 c\u00e1c thi\u1ebft b\u1ecb y t\u1ebf kh\u00e1c \u0111\u01b0\u1ee3c b\u1ed1 tr\u00ed \u0111\u1ec3 m\u00f4 ph\u1ecfng ph\u00f2ng sinh. Nh\u00e2n vi\u00ean \u0111i\u1ec1u khi\u1ec3n t\u1eebng t\u00ecnh hu\u1ed1ng t\u1eeb ph\u00f2ng \u0111i\u1ec1u khi\u1ec3n, \u0111\u01b0\u1ee3c ng\u0103n c\u00e1ch v\u1edbi ph\u00f2ng m\u00f4 ph\u1ecfng b\u1eb1ng m\u1ed9t t\u1ea5m g\u01b0\u01a1ng m\u1ed9t chi\u1ec1u. M\u00e0n h\u00ecnh TV trong ph\u00f2ng \u0111i\u1ec1u khi\u1ec3n hi\u1ec3n th\u1ecb video tr\u1ef1c ti\u1ebfp t\u1eeb c\u00e1c camera \u0111\u01b0\u1ee3c b\u1ed1 tr\u00ed kh\u1eafp ph\u00f2ng sinh gi\u1ea3 \u0111\u1ecbnh. M\u1ed7i t\u00ecnh hu\u1ed1ng \u0111\u1ec1u \u0111\u01b0\u1ee3c ghi h\u00ecnh \u0111\u1ec3 ng\u01b0\u1eddi tham gia c\u00f3 th\u1ec3 xem l\u1ea1i hi\u1ec7u su\u1ea5t c\u1ee7a m\u00ecnh.<\/p>\n

Khi s\u1eed d\u1ee5ng ma-n\u01a1-canh h\u00ecnh ph\u1ee5 n\u1eef mang thai trong m\u1ed9t t\u00ecnh hu\u1ed1ng, gi\u1ecdng n\u00f3i gi\u1ea3 c\u1ee7a ng\u01b0\u1eddi ph\u1ee5 n\u1eef s\u1ebd \u0111\u01b0\u1ee3c ph\u00e1t qua loa trong ph\u00f2ng m\u00f4 ph\u1ecfng. \u0110\u00f4i khi, m\u1ed9t nh\u00e2n vi\u00ean s\u1ebd v\u00e0o vai ng\u01b0\u1eddi m\u1eb9. Trong m\u1ed9t t\u00ecnh hu\u1ed1ng, c\u00f4 \u1ea5y gi\u1eef ma-n\u01a1-canh h\u00ecnh thai nhi sao cho vai c\u1ee7a thai nhi b\u1ecb k\u1eb9t trong t\u1eed cung khi sinh - m\u1ed9t t\u00ecnh tr\u1ea1ng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 kh\u00f3 \u0111\u1ebb vai.<\/p>\n

\u201cOBSim cho ph\u00e9p ch\u00fang t\u00f4i hi\u1ec3u r\u00f5 h\u01a1n v\u1ec1 vai tr\u00f2 c\u1ee7a m\u1ed7i ng\u01b0\u1eddi trong vi\u1ec7c ch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n,\u201d Julie Arafeh, RN, MSN, gi\u00e1m \u0111\u1ed1c \u0111\u00e0o t\u1ea1o v\u00e0 nghi\u00ean c\u1ee9u t\u1ea1i CAPE, cho bi\u1ebft. \u201cV\u00ed d\u1ee5, ch\u00fang t\u00f4i \u0111\u00e3 t\u1ea1o ra m\u1ed9t t\u00ecnh hu\u1ed1ng trong \u0111\u00f3 nh\u1ecbp tim thai nhi \u0111\u1ed9t ng\u1ed9t gi\u1ea3m. \u0110\u1ed1i v\u1edbi c\u00e1c b\u00e1c s\u0129 g\u00e2y m\u00ea, \u0111i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 c\u00f3 ngh\u0129a l\u00e0 s\u1ea3n ph\u1ee5 \u0111ang c\u00f3 ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i v\u1edbi thu\u1ed1c g\u00e2y t\u00ea ngo\u00e0i m\u00e0ng c\u1ee9ng, \u0111i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 \u0111\u00f2i h\u1ecfi ph\u1ea3i thay \u0111\u1ed5i l\u01b0\u1ee3ng thu\u1ed1c g\u00e2y m\u00ea \u0111\u01b0\u1ee3c truy\u1ec1n. B\u00e1c s\u0129 s\u1ea3n khoa c\u00f3 th\u1ec3 ngh\u0129 r\u1eb1ng c\u00f3 v\u1ea5n \u0111\u1ec1 v\u1ec1 nhau thai v\u00e0 c\u00e2n nh\u1eafc chuy\u1ec3n s\u1ea3n ph\u1ee5 v\u00e0o ph\u00f2ng m\u1ed5 \u0111\u1ec3 sinh. \u0110\u1ed1i v\u1edbi c\u00e1c \u0111i\u1ec1u d\u01b0\u1ee1ng, ch\u00fang t\u00f4i t\u1ef1 nh\u1ee7, d\u00f9 c\u00f3 chuy\u1ec7n g\u00ec x\u1ea3y ra, ch\u00fang t\u00f4i c\u0169ng \u0111\u00e3 s\u1eb5n s\u00e0ng.\u201d<\/p>\n

OBSim c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 \u0111i\u1ec3m m\u1ea1nh v\u00e0 \u0111i\u1ec3m y\u1ebfu trong m\u00f4i tr\u01b0\u1eddng b\u1ec7nh vi\u1ec7n th\u1ef1c t\u1ebf. N\u0103m 2008, c\u00e1c y t\u00e1 c\u1ee7a Packard \u0111\u00e3 tham gia m\u1ed9t cu\u1ed9c di\u1ec5n t\u1eadp m\u00f4 ph\u1ecfng m\u1ed9t ph\u1ee5 n\u1eef b\u1ecb xu\u1ea5t huy\u1ebft sau sinh. Trong t\u00ecnh hu\u1ed1ng n\u00e0y, ng\u01b0\u1eddi ph\u1ee5 n\u1eef b\u1ecb ch\u1ea3y m\u00e1u r\u1ea5t nhi\u1ec1u, v\u00e0 m\u1ed9t y t\u00e1 \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn l\u1ea5y thu\u1ed1c nhanh ch\u00f3ng t\u1eeb m\u1ed9t h\u1ec7 th\u1ed1ng m\u00e1y t\u00ednh g\u1ecdi l\u00e0 Pyxis - thi\u1ebft b\u1ecb ti\u00eau chu\u1ea9n t\u1ea1i Packard v\u00e0 nhi\u1ec1u b\u1ec7nh vi\u1ec7n kh\u00e1c.<\/p>\n

\u201cPyxis mang l\u1ea1i m\u1ed9t m\u1ee9c \u0111\u1ed9 an to\u00e0n nh\u1ea5t \u0111\u1ecbnh,\u201d Daniels gi\u1ea3i th\u00edch. \u201cV\u00ed d\u1ee5, n\u1ebfu b\u1ea1n y\u00eau c\u1ea7u m\u1ed9t lo\u1ea1i thu\u1ed1c m\u00e0 b\u1ec7nh nh\u00e2n b\u1ecb d\u1ecb \u1ee9ng, Pyxis s\u1ebd kh\u00f4ng cho b\u1ea1n l\u1ea5y thu\u1ed1c ra cho \u0111\u1ebfn khi b\u1ea1n nh\u1eadp t\u00ean b\u1ec7nh nh\u00e2n v\u00e0 nh\u1eadn \u0111\u01b0\u1ee3c x\u00e1c th\u1ef1c sinh tr\u1eafc h\u1ecdc b\u1eb1ng c\u00e1ch \u0111\u1eb7t ng\u00f3n tay l\u00ean m\u00e0n h\u00ecnh. Nh\u01b0ng n\u1ebfu s\u1ea3n ph\u1ee5 \u0111ang ch\u1ea3y 700 cc m\u00e1u m\u1ed7i ph\u00fat, b\u1ea1n c\u1ea7n ph\u1ea3i h\u00e0nh \u0111\u1ed9ng nhanh ch\u00f3ng.\u201d<\/p>\n

Khi Daniels v\u00e0 c\u00e1c \u0111\u1ed3ng nghi\u1ec7p xem l\u1ea1i video v\u1ec1 m\u00e1y khoan Pyxis, h\u1ecd ph\u00e1t hi\u1ec7n ra r\u1eb1ng y t\u00e1 ph\u1ea3i m\u1ea5t h\u01a1n hai ph\u00fat \u0111\u1ec3 l\u1ea5y \u0111\u01b0\u1ee3c t\u1ea5t c\u1ea3 c\u00e1c lo\u1ea1i thu\u1ed1c c\u1ea7n thi\u1ebft, v\u00ec m\u1ed7i lo\u1ea1i thu\u1ed1c ph\u1ea3i \u0111\u01b0\u1ee3c nh\u1eadp ri\u00eang l\u1ebb. "Ch\u00fang t\u00f4i \u0111\u00e3 li\u00ean h\u1ec7 v\u1edbi c\u00f4ng ty s\u1ea3n xu\u1ea5t Pyxis v\u00e0 h\u1ecd \u0111\u00e3 \u0111\u1ed3ng \u00fd c\u1ea3i thi\u1ec7n t\u00ednh n\u0103ng sinh tr\u1eafc h\u1ecdc", Daniels n\u00f3i. "Sau \u0111\u00f3, ch\u00fang t\u00f4i \u0111\u00e3 l\u00e0m vi\u1ec7c v\u1edbi nh\u00e0 thu\u1ed1c \u0111\u1ec3 t\u1ea1o ra m\u1ed9t b\u1ed9 d\u1ee5ng c\u1ee5 cho ph\u00e9p l\u1ea5y t\u1ea5t c\u1ea3 c\u00e1c lo\u1ea1i thu\u1ed1c c\u00f9ng m\u1ed9t l\u00fac. L\u1ea7n ti\u1ebfp theo ch\u00fang t\u00f4i ch\u1ea1y m\u00e1y khoan, y t\u00e1 ch\u1ec9 m\u1ea5t 29 gi\u00e2y \u0111\u1ec3 l\u1ea5y \u0111\u00fang lo\u1ea1i thu\u1ed1c c\u1ea7n l\u1ea5y."<\/p>\n

Xu\u1ea5t huy\u1ebft sau sinh x\u1ea3y ra \u1edf kho\u1ea3ng 4% ca sinh, v\u00ec v\u1eady h\u1ec7 th\u1ed1ng m\u1edbi \u0111\u01b0\u1ee3c tinh gi\u1ea3n n\u00e0y c\u00f3 th\u1ec3 c\u1ee9u s\u1ed1ng nhi\u1ec1u ph\u1ee5 n\u1eef. "T\u1ef7 l\u1ec7 t\u1eed vong \u1edf b\u00e0 m\u1eb9 do xu\u1ea5t huy\u1ebft v\u00e0 c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c \u0111ang gia t\u0103ng \u1edf Hoa K\u1ef3, v\u00e0 \u0111i\u1ec1u \u0111\u00f3 l\u00e0 kh\u00f4ng th\u1ec3 ch\u1ea5p nh\u1eadn \u0111\u01b0\u1ee3c", Ti\u1ebfn s\u0129 Steven Lipman, ph\u00f3 gi\u00e1o s\u01b0 l\u00e2m s\u00e0ng khoa G\u00e2y m\u00ea v\u00e0 \u0111\u1ed3ng gi\u00e1m \u0111\u1ed1c Ch\u01b0\u01a1ng tr\u00ecnh OBSim, cho bi\u1ebft.<\/p>\n

\u201c\u0110\u01b0\u1ee3c tham gia OBSim th\u1eadt s\u1ef1 r\u1ea5t th\u00fa v\u1ecb, k\u00edch th\u00edch tr\u00ed tu\u1ec7 v\u00e0 mang l\u1ea1i s\u1ef1 h\u00e0i l\u00f2ng,\u201d \u00f4ng n\u00f3i th\u00eam. \u201cB\u1eb1ng c\u00e1ch l\u00e0m vi\u1ec7c c\u00f9ng nhau, ch\u00fang t\u00f4i \u0111\u00e3 ph\u00e1 v\u1ee1 c\u00e1c r\u00e0o c\u1ea3n v\u00e0 t\u1ea1o n\u00ean m\u1ed9t tinh th\u1ea7n \u0111\u1ed3ng \u0111\u1ed9i, \u0111i\u1ec1u \u0111\u00e3 thay \u0111\u1ed5i v\u0103n h\u00f3a t\u1ea1i Packard. Hi\u1ec7n t\u1ea1i, ch\u00fang t\u00f4i \u0111ang th\u1ef1c hi\u1ec7n c\u00e1c bu\u1ed5i th\u0103m kh\u00e1m \u0111a chuy\u00ean khoa nh\u00f3m m\u1ed7i ng\u00e0y cho t\u1eebng b\u1ec7nh nh\u00e2n. M\u1ecdi ng\u01b0\u1eddi \u0111\u1ec1u c\u00f3 c\u01a1 h\u1ed9i c\u00f9ng nhau l\u1eadp k\u1ebf ho\u1ea1ch \u0111i\u1ec1u tr\u1ecb. \u0110\u00f3 ch\u00ednh l\u00e0 k\u1ebft qu\u1ea3 tr\u1ef1c ti\u1ebfp c\u1ee7a OBSim.\u201d<\/p>\n

\u0110\u00e0o t\u1ea1o th\u1ebf h\u1ec7 ti\u1ebfp theo<\/h2>\n

Ngo\u00e0i vi\u1ec7c \u0111i \u0111\u1ea7u trong nghi\u00ean c\u1ee9u s\u1ea3n khoa, Packard v\u00e0 Stanford \u0111\u00e3 ph\u00e1t tri\u1ec3n m\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh \u0111\u00e0o t\u1ea1o v\u00e0 gi\u00e1o d\u1ee5c s\u00e1ng t\u1ea1o d\u00e0nh cho c\u00e1c b\u00e1c s\u0129 s\u1ea3n khoa t\u01b0\u01a1ng lai.<\/p>\n

B\u1ec7nh vi\u1ec7n Nhi Packard l\u00e0 m\u1ed9t trong s\u1ed1 \u00edt b\u1ec7nh vi\u1ec7n t\u1ea1i California \u00e1p d\u1ee5ng "m\u00f4 h\u00ecnh m\u1edf", trong \u0111\u00f3 c\u00e1c b\u00e1c s\u0129 t\u01b0 nh\u00e2n l\u00e0m vi\u1ec7c c\u00f9ng v\u1edbi gi\u1ea3ng vi\u00ean tr\u01b0\u1eddng y. Kho\u1ea3ng m\u1ed9t n\u1eeda s\u1ed1 ph\u1ee5 n\u1eef mang thai nh\u1eadp vi\u1ec7n t\u1ea1i Packard \u0111\u01b0\u1ee3c c\u00e1c b\u00e1c s\u0129 t\u01b0 nh\u00e2n ch\u0103m s\u00f3c.<\/p>\n

\u201c\u0110\u00e2y l\u00e0 m\u1ed9t s\u1ef1 k\u1ebft h\u1ee3p tuy\u1ec7t v\u1eddi,\u201d Druzin n\u00f3i. \u201cC\u00e1c b\u00e1c s\u0129 n\u1ed9i tr\u00fa v\u00e0 th\u1ef1c t\u1eadp sinh \u0111\u01b0\u1ee3c h\u1ecdc h\u1ecfi t\u1eeb \u0111\u1ed9i ng\u0169 gi\u1ea3ng vi\u00ean uy t\u00edn t\u1ea1i tr\u01b0\u1eddng y v\u00e0 t\u1eeb c\u00e1c b\u00e1c s\u0129 gi\u00e0u kinh nghi\u1ec7m h\u00e0nh ngh\u1ec1 t\u01b0 nh\u00e2n. \u0110\u00e2y l\u00e0 n\u1ec1n gi\u00e1o d\u1ee5c t\u1ed1t nh\u1ea5t c\u00f3 th\u1ec3, v\u00e0 \u0111\u00e3 t\u1ea1o n\u00ean m\u1ed9t trong nh\u1eefng ch\u01b0\u01a1ng tr\u00ecnh \u0111\u00e0o t\u1ea1o v\u00e0 n\u1ed9i tr\u00fa s\u1ea3n ph\u1ee5 khoa h\u00e0ng \u0111\u1ea7u c\u1ea3 n\u01b0\u1edbc.\u201d<\/p>\n

Hi\u1ec7n nay, Tr\u01b0\u1eddng Y Stanford tuy\u1ec3n sinh n\u0103m b\u00e1c s\u0129 n\u1ed9i tr\u00fa m\u1ed7i n\u0103m cho ch\u01b0\u01a1ng tr\u00ecnh \u0111\u00e0o t\u1ea1o b\u1ed1n n\u0103m v\u1ec1 s\u1ea3n ph\u1ee5 khoa t\u1ed5ng qu\u00e1t. Ngo\u00e0i ra, c\u00f2n c\u00f3 m\u1ed9t ch\u01b0\u01a1ng tr\u00ecnh h\u1ecdc b\u1ed5ng ba n\u0103m v\u1ec1 y h\u1ecdc b\u00e0 m\u1eb9 v\u00e0 thai nhi, m\u1ed7i n\u0103m ch\u1ec9 tuy\u1ec3n m\u1ed9t ng\u01b0\u1eddi, cung c\u1ea5p ch\u01b0\u01a1ng tr\u00ecnh \u0111\u00e0o t\u1ea1o v\u1ec1 s\u1ea3n khoa nguy c\u01a1 cao. Ch\u01b0\u01a1ng tr\u00ecnh n\u00e0y c\u1ea5p ch\u1ee9ng ch\u1ec9 chuy\u00ean khoa ph\u1ee5 v\u00e0 \u0111\u1ecbnh h\u01b0\u1edbng ngh\u1ec1 nghi\u1ec7p cho sinh vi\u00ean t\u1ed1t nghi\u1ec7p trong l\u0129nh v\u1ef1c y h\u1ecdc h\u00e0n l\u00e2m.<\/p>\n

El-Sayed l\u01b0u \u00fd r\u1eb1ng \u0111\u00e0o t\u1ea1o chuy\u00ean khoa v\u00e0 nghi\u00ean c\u1ee9u ch\u1ea5t l\u01b0\u1ee3ng cao lu\u00f4n song h\u00e0nh. "T\u1ea7m nh\u00ecn c\u1ee7a ch\u00fang t\u00f4i t\u1ea1i Packard l\u00e0 th\u1ef1c hi\u1ec7n c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn vi\u1ec7c ch\u0103m s\u00f3c ph\u1ee5 n\u1eef mang thai tr\u00ean to\u00e0n th\u1ebf gi\u1edbi", \u00f4ng n\u00f3i. "\u0110\u1ec3 l\u00e0m \u0111\u01b0\u1ee3c \u0111i\u1ec1u \u0111\u00f3, ch\u00fang t\u00f4i c\u1ea7n h\u1ed7 tr\u1ee3 c\u00e1c nghi\u00ean c\u1ee9u sinh v\u00e0 gi\u1ea3ng vi\u00ean th\u00f4ng qua c\u00e1c kho\u1ea3n t\u00e0i tr\u1ee3 nghi\u00ean c\u1ee9u kh\u00f4ng gi\u1edbi h\u1ea1n. Nghi\u00ean c\u1ee9u s\u1ea3n khoa lu\u00f4n b\u1ecb thi\u1ebfu kinh ph\u00ed. N\u1ebfu c\u00e1c nh\u00e0 t\u00e0i tr\u1ee3 \u0111ang ngh\u0129 \u0111\u1ebfn vi\u1ec7c gi\u00fap \u0111\u1ee1 tr\u1ebb em, h\u00e3y nh\u1edb r\u1eb1ng, t\u1ea5t c\u1ea3 \u0111\u1ec1u b\u1eaft \u0111\u1ea7u t\u1eeb qu\u00e1 tr\u00ecnh mang thai."<\/p>\n

 <\/p>","protected":false},"excerpt":{"rendered":"

M\u1ed9t th\u1ebf k\u1ef7 tr\u01b0\u1edbc, vi\u1ec7c sinh n\u1edf \u1edf Hoa K\u1ef3 kh\u00f4ng h\u1ec1 \u0111\u01a1n gi\u1ea3n. Trung b\u00ecnh, c\u1ee9 m\u1ed7i\u2026<\/p>","protected":false},"author":17,"featured_media":3588,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[148,22],"class_list":["post-3587","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-in-the-news","category-patient-stories"],"acf":[],"yoast_head":"\nObstetrics: Raising the Bar - Lucile Packard Foundation for Children's Health<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"http:\/\/lpfch.org\/vi\/impact-stories\/obstetrics-raising-the-bar\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Obstetrics: Raising the Bar\" \/>\n<meta property=\"og:description\" content=\"A century ago, childbirth in the United States was anything but routine. 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