11 12 tun th vic tnh tui thai s cc chnh xc da vo cc ch s ca thai nhi.

Siu m o dy vai gy: c thc hin t tun th 11 12. kt hp vi tui m v xt nghim Double
test tnh ton nguy c hi chng Down ca b giai on sm ca thai k
< 3mm th c xp vo nhm nguy c thp
3.5-4.4mm c t l bt thng nhim sc th l 21.1%
6.5 mm bt thng nhim sc th ln ti 64.5%.
>3mm, th vo tun l 16-18 thai k triple test (gm alpha-fetoprotein, hCG v unconjugated estriol). nguy
c hi chng Down, trisomy 18 v cc khim khuyt ng thn kinh.
1/200 th nguy c trisomy 21
60% nu m di 35 tui
75% nu m trn 35 tui.
1/100, nguy c thai nhi b trisomy 18 cao -100
hCG, AFP v estriol. T c th tnh c nguy c khuyt tt ca bo thai.
Ngoi kt qu xt nghim vi mu, cc nguy c d tt bo thai cn c nh lng trn cc yu t nh tui
tc, cn nng, chng tiu ng hoc nhng bt thng v gene ca ngi m
Siu m 3-4 chiu gm 12 tun, 22 tun v 32 tun.
12 tun o m da gy phi hp vi xt nghim PAPPA v Beta HCG mu m s gip pht hin 90% tr
Down,
75% tr Down s c da gy d
Thai 22 tun l thi im l tng kho st hnh thi hc thai nhi, nc i rng ri v thai ln c th
nhn thy c cc cu trc. Nu thai c d tt nng phi chm dt thai k th c th cho sn ph sanh non
Thai 32 tun: siu m mu, nh gi tnh trng sc kho thai nhi bng vic o cc thng s Doppler ng
mch rn, ng mch no gia qui c mu khi dng mu hng v u d siu m v mu xanh khi
dng mu ri xa u d siu m.
Ly nc tiu gia qung trnh kt qu dng tnh gi albumin
nc tiu xut hin albumin c kh nng b nhim trng ng tit niu hoc mc hi chng huyt p cao
khi mang thai.
Khi thai ph b bnh ny th thai nhi c nguy c b mt trong nhng d tt:
1.
2.
3.
4.

khim khuyt ng thn kinh,

nt t sng,
d tt v tim thn,
thai s ln (hn 4,2 kg) gy kh,

tr sinh ra s b suy h hp v vim ph qun.

Double test c thc hin qu I ca thai k (t 11 tun 1 ngy n 13 tun 6 ngy). Down, Edward hoc Patau
qu 1
Nu Double Test ch ra nguy c d tt bm sinh cao (dng tnh), cn phi tin hnh chn on xc nh bng sinh thit
nhung mao mng m nhau thai. Nu thai c nguy c d tt bm sinh mc ranh gii, cn th tip Triple test qu II
ca thai k nh gi mc nguy c r rng hn.
ong 16-18 tun tui ca thai nhi s cho kt qu chnh xc nht (xt nghim huyt thanh AFP, Free - hCG v uE3, sau
kt hp gi tr xt nghim vi tui m, cn nng m, chng tc, tui thai, s thai),
1.

hi chng Down,

2. d tt ng thn kinh rt hay gp (bt thng no v ty sng) v

3. nguy c ca tam nhim sc th 18.
Nhng mt iu ch gia Double test v Triple test l Double test gip pht hin sm nguy c b Down, cn
Triple test pht hin thm nguy c thai c b d tt ng thn kinh hay khng.
Khi xt nghim Double test v Triple test r nguy c cao th s lm chc i. Vic chc i xt nghim nhim
sc th s bit chnh xc c b thai Down hay khng.
Tip theo, bn c th c kim tra mu xc nh nhm mu, tnh trng Rh cng nh kim tra chng thiu mu b
bu.
Ngoi ra, xt nghim mu cn xc nh cc bnh:
- Giang mai.
- Vim gan B.
- Si c (Rubella).
- Thy u.
Cui cng, vic xt nghim mu ban u cng tm c kt qu HIV.
Trong mi ln thm khm giai on 2, bc s ca bn s yu cu kim tra nc tiu tm du hiu ca chng tin
sn git, nhim trng ng tit niu v cc bnh khc.
Trong khong thi gian t tun 24 28, bn s c tin hnh xt nghim sng lc glucose kim tra xem c b bnh
i tho ng thai k hay khng v c th c xt nghim mu kim tra thiu mu.
chc i kim tra trong thi gian t tun 16 20.
Ba thng cui mang thai
Trong giai on th ba, cc bc s s tip tc yu cu bn tin hnh kim tra mu nc tiu xc nh
du hiu ca chng tin sn git, nhim trng ng tit niu v cc du hiu khc.
T tun 35 37, bn s c xt nghim xc nh cc bnh nhim trng thng thng. Nu xt nghim
cho kt qu dng tnh, bn s c bc s k thuc khng sinh trong qu trnh sinh n gi cho vi khun
khng xm nhp vo em b trong qu trnh chui ra.

Lu rng nu bn b l thi gian khm thai ny th khi bc sang tun 13, cc ch s ny s

khng chnh xc, khng c gi tr chn on na
bn ung vin st hoc cc loi vitamin tng hp
Xt nghim Triple Test: Tun thai th 16 17. AFP (loi protein do thai sn xut), hCG (loi ni
tit do nhau thai sn xut) v Estriol (l loi ni tit estrogen c nhau thai v thai nhi sn
xut).
guy c b ri lon di truyn nhim sc th v c cn phi lm thm xt nghim khc na khng.
. Sim m 4D c thc hin trong tun thai th 22 24. t mi, d dng c quan, c bit l
cc bt thng v tim v h xng
tun th 36 trc khi sinh, ng mu trc khi sinh.
Tim vaccine un vn Tun th 30 32

Tun 35 36, thi gian gn sinh thai ph s c bc s tin hnh siu m theo di doppler
ng mch no, ng mch t cung cng nh kim tra lng nc i, dy rn
non-stress (xt nghim theo di nhp tim thai n thun m khng cn to nn cn co t
cung) kim tra lng oxy thai nhi nhn c, kim tra sc kho ca b
Nhng xt nghim thc hin trong 3 thng u thai k
C 1 thng 1 ln, b bu s i khm thai nh k v c th phi tin hnh cc cuc xt nghim
sau:

Siu m.

Xt nghim mu MaterniT21PLUS.

Sinh thit gai nhau.

Chc i (nu cn).

Nhng xt nghim thc hin trong k tam c nguyt th 2

T tun 13-26 ca thai k, b bu vn theo lch khm thai 1 thng/ln nh c, nhng nu c g
bt thng, cc bui khm thai c th rt st nhau theo yu cu ca bc s.

Sng lc thai nhi.

Chc i (nu cn).

Siu m.

Nhng xt nghim mang thai 3 thng cui cn lm

Sau tun thai th 27, 28, b bu s phi thng xuyn i khm thai nhiu hn. Khong tun
th 36, lch khm thai hng tun c th c yu cu m bo sc khe cho m v b.
Khng t trng hp m bu phi kim tra hng ngy t tun 41 tr i. Cc xt nghim c th
c yu cu:

Xt nghim tiu ng thai k.

Test khng kch.

Trc sinh vt l.

Xt nghim OCT.

Chc i (nu cn).

Siu m.