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  • QUN L SN PHC NGUY C CAOYoo Kuen ChanTRNG I HC TRUNG TM Y KHOA MALAYA

  • V TR CA MALAYSIA

  • NI DUNG nh nghaNhn bit nhm nguy cXp loi yu t nguy cK hoch sn khoa v GMHSGim au/v cm lc sinh cho LSCSChin lc cho cc tnh hung khn cpNhng tiu im mi

  • SN PH NGUY C CAOSn phc c xem l nguy c cao cho ngi lm GMHS nu c cc tnh trng bnh l, bin chng sn khoa, c th phi m Cesar hay c kh nng phi c v cmDavid J Birnbach

  • SN PH NGUY C CAOCuc sng ca sn ph v thai nhi c th b e da trong sut qu trnh mang thai hay tin trnh sinh sn ? Mt sn ph m c kh nng kt lun nh l mt con s thng k v t l t vong hay t l tai bin

  • HNH NH CA SN PH NGUY C CAO(1985 2008 bo co mi 3 nm, UK)

  • HNH NH CA SN PH NGUY C CAO(2000 2002 bo co mi 3 nm, UK)

  • NGYN NHN T VONG MMalaysia (1997 2000)

  • nh tng bng = T l t vong

    y tng bng = T l tai bin nng

  • NGUY C NI BT

  • lc khi pht, bnh d iu tr nhng kh pht hin, nhng theo thi gian khng pht hin v iu tr bnh tr nn d pht hin nhng kh iu tr

    Nicolo Maichiavelli, Hong t

  • TI SAO T VONG M ?(1997 1999)Khng nhn ra s hin hu ca bnhKhng nhn ra mc mt bKhng khm chuyn khoaSn ph khng tun theo cc khuyn co

  • Nhng im hc c t bo co ca UK(2000 2002)

  • CC TRIU CHNG CA SN PH BNH TIMMt miTh ngnKh th theo t thPh ngoi binHi hp

  • PHN LOI NGUY C(Clark SL, 1997)Nhm 1 (TLTV < 1%)Thng lin nhThng lin thtCn ng ng mchBnh van MP, van 3 lT chng Fallot PTThay van timHp van 2 l, NYHA 1 v 2

  • PHN LOI NGUY C(Clark SL, 1997)Nhm 2 (TLTV 5 15%)Hp van 2 l c rung nhVan nhn toHp van 2 l, NYHA 3 v 4Hp van MCTeo MC khng bin chngT chng Fallot khng PT c NMCTHC Marfan MC bnh thng

  • PHN LOI NGUY C(Clark SL, 1997)Nhm 3 (TLTV 25 50%)Cao p phiTeo MC c bin chngHC Marfan nh hng MC

  • CHM SC PH HPTnh hung l tng nhn vin c trnh chm sc cho ng mc chm sc Chm sc ph hpCung cp mc chm sc thch hp cho nhu cu nhng nhm bnh nhn la chn trong s cc bnh nhn nguy c cao

  • TI SAO M T VONG ?(Chng 10 bnh tim 1994 1996)

  • CC H THNG THCH HPLm vic theo nhmK hoch thch hp v thi im sinhProtocol v tp dt ci thin chm sc khn cpThng k ci thin h thng

  • M HA

  • K HOCH QUN L SN KHOAIJOA 2003;12:28-34

  • NGUY C LIN QUAN T VONG DO THI IM V PHNG PHP SINH, UK (2000 2002)

  • K HOCH Analgesia & AnesthesiaIJOA 2003;12:28-34

  • K HOCH CA Analgesia & AnesthesiaTy theo nhu cu sinhTy theo nhu cu ca bnh nhnTD nu l bnh nhn tim, cn duy tr n nh tim mchDuy tr tin tiDuy tr nhp xoangTrnh nhanh nhp timTrnh h nhp tim nngTrnh H HATrnh c ch c tim

  • Gy t vng iu chnh c c th an ton c s dng cho nhng sn ph bnh tim c nguy c cao

  • SN PH NGUY C CAO KHN CPBao gm nhm c th xut hin v hi nh l mt cuc sinh bnh thngNhn dng, bo ng v cung cp chm sc khng ng nhng nhn vin tr kinh nghim gii hn ONUS l mt h thng sc khe bo m chm sc cp cao cho tt c bt chp tnh trng khn cp

  • CI THIN SC KHE(cc chnh sch)

  • CI THIN TAY NGH NHN VIN Y T

  • CH NH THI GIAN CHO NHNG TRNG HP NGUY C CAO

  • THNG K THCH HP/S LIU Ci thin h thng r rtPooled data s tt hnChng trnh ng k sn ph nguy c cao UK,, ICNARC ca nhp vin sn khoaChng trnh ng k theo vng ca sn ph c nguy c cao ?

  • NGUY C T L T VONG M QUA CC NM, UK

  • BNH VIN SN PH NGUY C CAO

  • H THNG CNH BO SN PH SM C SA I

  • BN GIAO SN PH AN TONBnh nng : Gm, nhim trng huyt, tin sn git, bnh ton thn nng v nhng ngi cn chm sc caoC nguy c : PT Cesar khn, chy mu hay tai vn v GMHS nh bnh nhau thai, vn v thai nhi, song thai, bo ph, ri lon ng mu, t NKQ khTheo di : Gm au u sau thng mng cng, chy mu sn khoa nng hay tn thng TK sau t vngT NMC : Bn c gy t NMC hay c tai bin do t NMC cn xem xt hay t li

  • KU GI HNH NG

  • CHM SC CHO SN PH NGUY C CAOAn tonnh thi gianHiu quHiu quCng bngLy bnh nhn lm trung tm

  • TM TTTht bi ca mt s bc s sn khoa v n h sinh trong vic nhn bit v hnh ng i vi cc tnh trng y khoa l do thiu kinh nghimTht bi ca nhm hi sc cp cu trong vic nhn ra s nghim trng ca sn ph v i hi s nh gi ca bc s sn khoa v n h sinhThiu theo di ch ng nhng sn ph c bit khng nhp vin sn sc trc khi sinh, c bit l nhng sn ph c xem nh c nguy c caoTt bi ca cc bc s a khoa v cc chuyn khoa v vic b qua cc thng tin y khoa trc y v hin ti trong th gii thiu chuyn vin hay in thoi t phng cho cc dng ng hay nhm sn sc sn ph trong thi gian mang thai ca sn ph

  • XIN CM N