Upload
ditana2203
View
38
Download
2
Embed Size (px)
Citation preview
KH DO VAI
KH DO VAINHM 5 CLB Sn Ph khoa- H Y dc Hu
inh Thanh NhnV Th Phng LinNguyn Thanh HoiNguyn Th HngTrn Vn BuShoulder dystociaGV hng dn: Ths.BS Trn Mnh Linh
NI DUNG
i cngYu t nguy cBin chngChn onD phng trc sinhX tr trong lc sinhTng kt
I CNG
kh do vai l g?Mt cuc ng m oS vai tht bii hi thm cc th thut sn khoa khc
ngiXng mu
I CNG
T l chung => thay i theo cn nng thai nhi2,5 4kg0,6 1,4%4 4,5kg5 9%Khng th d bo chnh xc v d phng c
Cp cu
ui hnh bt ch
Mt trong nhng yu t nguy c ca KDV:
I THO NG
ui hnh bt chMt trong nhng yu t nguy c ca KDV:
BO PH
ui hnh bt chMt trong nhng yu t nguy c ca KDV:
THAI TO
ui hnh bt chMt trong nhng yu t nguy c ca KDV:
PHA TCH CC KO DI
YU T NGUY C
7% (Keller)Th no l thai to?
Cn nng tr s sinh > 90th percentile so vi tui thai
ACOG: 4500g
Hn ch:Cn nng cng cao => km chnh xc
Qu III: nhy 60% (thai>4,5kg)
Yu t nguy c thai to
M bo ph TMang thai nhiu ln gi tr tin on khng cao=>KHNG SNG LC
BIN CHNG
Tng ln khi:
Th thut Zavanelli
Rch khp mu
Tn thng m ri thn kinh cnh tay
lit Erb-Duschennelit Klumpke
CHN ON
u s ra nhng b p cht vo m hCm b tht li vo tng sinh mnDu hiu c ra (turtle sign)
13
CHN ON
Du hiu c ra Thi gian t khi s u n s thai >60sCn s dng th thut sn khoa
ACOG khuyn co: Kh s mt v cmDu hiu c rau khng tr v c v tr ban uVai khng xung c
D PHNG TRC SINH
25-50% khng xc nh c yu t nguy c
50% trng hp xy ra tr c cn nng lc sinh