{"id":54972,"date":"2022-10-13T15:45:12","date_gmt":"2022-10-13T08:45:12","guid":{"rendered":"https:\/\/pharmog.com\/wp\/?p=54972"},"modified":"2025-01-07T21:25:33","modified_gmt":"2025-01-07T14:25:33","slug":"ethinylestradiol-etonogestrel","status":"publish","type":"post","link":"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/","title":{"rendered":"Ethinylestradiol + Etonogestrel"},"content":{"rendered":"<h1><span class=\"ez-toc-section\" id=\"thong-tin-chung-cua-thuoc-ket-hop-ethinylestradiol-etonogestrel\"><\/span>Th\u00f4ng tin chung c\u1ee7a thu\u1ed1c k\u1ebft h\u1ee3p Ethinylestradiol + Etonogestrel<span class=\"ez-toc-section-end\"><\/span><\/h1>\n<p><em>D\u01b0\u1edbi \u0111\u00e2y l\u00e0 n\u1ed9i dung t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng g\u1ed1c c\u1ee7a Thu\u1ed1c k\u1ebft h\u1ee3p Ethinylestradiol + Etonogestrel (Th\u00f4ng tin bao g\u1ed3m li\u1ec1u d\u00f9ng, c\u00e1ch d\u00f9ng, ch\u1ec9 \u0111\u1ecbnh, ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, th\u1eadn tr\u1ecdng, d\u01b0\u1ee3c l\u00fd&#8230;)<\/em><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_81 ez-toc-wrap-left counter-hierarchy ez-toc-counter ez-toc-white ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">N\u1ed9i dung ch\u00ednh<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-1'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#thong-tin-chung-cua-thuoc-ket-hop-ethinylestradiol-etonogestrel\" >Th\u00f4ng tin chung c\u1ee7a thu\u1ed1c k\u1ebft h\u1ee3p Ethinylestradiol + Etonogestrel<\/a><ul class='ez-toc-list-level-2' ><li class='ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#1-ten-hoat-chat-va-biet-duoc\" >1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#2-dang-bao-che-%e2%80%93-ham-luong\" >2. D\u1ea1ng b\u00e0o ch\u1ebf &#8211; H\u00e0m l\u01b0\u1ee3ng:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#3-video-by-pharmog\" >3. Video by Pharmog:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#4-ung-dung-lam-sang\" >4. \u1ee8ng d\u1ee5ng l\u00e2m s\u00e0ng:<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#41-chi-dinh\" >4.1. Ch\u1ec9 \u0111\u1ecbnh:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#42-lieu-dung-%e2%80%93-cach-dung\" >4.2. Li\u1ec1u d\u00f9ng &#8211; C\u00e1ch d\u00f9ng:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#43-chong-chi-dinh\" >4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#44-than-trong\" >4.4 Th\u1eadn tr\u1ecdng:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#45-su-dung-cho-phu-nu-co-thai-va-cho-con-bu\" >4.5 S\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 cho con b\u00fa:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#46-tac-dung-khong-mong-muon-adr\" >4.6 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n (ADR):<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#47-huong-dan-cach-xu-tri-adr\" >4.7 H\u01b0\u1edbng d\u1eabn c\u00e1ch x\u1eed tr\u00ed ADR:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#48-tuong-tac-voi-cac-thuoc-khac\" >4.8 T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#49-qua-lieu-va-xu-tri\" >4.9 Qu\u00e1 li\u1ec1u v\u00e0 x\u1eed tr\u00ed:<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#5-co-che-tac-dung-cua-thuoc\" >5. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c :<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#51-duoc-luc-hoc\" >5.1. D\u01b0\u1ee3c l\u1ef1c h\u1ecdc:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#52-duoc-dong-hoc\" >5.2. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-18\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#53-hieu-qua-lam-sang\" >5.3. Hi\u1ec7u qu\u1ea3 l\u00e2m s\u00e0ng:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-19\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#54-du-lieu-tien-lam-sang\" >5.4. D\u1eef li\u1ec7u ti\u1ec1n l\u00e2m s\u00e0ng:<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-20\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#6-phan-thong-tin-kem-theo-cua-thuoc\" >6. Ph\u1ea7n th\u00f4ng tin k\u00e8m theo c\u1ee7a thu\u1ed1c:<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-21\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#61-danh-muc-ta-duoc\" >6.1. Danh m\u1ee5c t\u00e1 d\u01b0\u1ee3c:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-22\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#62-tuong-ky\" >6.2. T\u01b0\u01a1ng k\u1ef5 :<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-23\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#63-bao-quan\" >6.3. B\u1ea3o qu\u1ea3n:<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-24\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#64-thong-tin-khac\" >6.4. Th\u00f4ng tin kh\u00e1c :<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-25\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#65-tai-lieu-tham-khao\" >6.5 T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-26\" href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/#7-nguoi-dang-tai-tac-gia\" >7. Ng\u01b0\u1eddi \u0111\u0103ng t\u1ea3i \/T\u00e1c gi\u1ea3:<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n\n<h2><span class=\"ez-toc-section\" id=\"1-ten-hoat-chat-va-biet-duoc\"><\/span>1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><strong><em>Ho\u1ea1t ch\u1ea5t :<\/em> <a href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel\/\">Ethinylestradiol + Etonogestrel<\/a><\/strong><\/p>\n<p><strong><em>Ph\u00e2n lo\u1ea1i: <\/em><\/strong><em>Thu\u1ed1c tr\u00e1nh thai.<\/em><\/p>\n<p><strong><em>Nh\u00f3m<\/em><\/strong> <strong><em>ph\u00e1p l\u00fd: <\/em><\/strong><em>Thu\u1ed1c k\u00ea \u0111\u01a1n ETC \u2013 (Ethical drugs, prescription drugs, Prescription only medicine)<\/em><\/p>\n<p><strong><em>M\u00e3 ATC<\/em><\/strong> (Anatomical Therapeutic Chemical): G02BB01.<\/p>\n<p><strong><em>Bi\u1ec7t d\u01b0\u1ee3c g\u1ed1c:<\/em><\/strong><\/p>\n<p><strong><em>Thu\u1ed1c Generic<\/em><\/strong>: <a href=\"https:\/\/pharmog.com\/wp\/ethinylestradiol-etonogestrel-nuvaring\/\">Nuvaring<\/a>.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<h2><span class=\"ez-toc-section\" id=\"2-dang-bao-che-%e2%80%93-ham-luong\"><\/span>2. D\u1ea1ng b\u00e0o ch\u1ebf &#8211; H\u00e0m l\u01b0\u1ee3ng:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><strong><em>D\u1ea1ng thu\u1ed1c v\u00e0 h\u00e0m l\u01b0\u1ee3ng<\/em><\/strong><\/p>\n<p>V\u00f2ng \u0111\u1eb7t \u00e2m \u0111\u1ea1o: M\u1ed7i v\u00f2ng ch\u1ee9a Etonogestrel 11,7 mg; Ethinylestradiol 2,7 mg.<\/p>\n<p><strong><em>Thu\u1ed1c tham kh\u1ea3o:<\/em><\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td colspan=\"2\"><strong><em>ORNIBEL<\/em><\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><em>M\u1ed7i v\u00f2ng \u0111\u1eb7t c\u00f3 ch\u1ee9a:<\/em><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Ethinylestradiol<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>2,7 mg<\/td>\n<\/tr>\n<tr>\n<td>Etonogestrel<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>11,7 mg<\/td>\n<\/tr>\n<tr>\n<td>T\u00e1 d\u01b0\u1ee3c<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>v\u1eeba \u0111\u1ee7 (Xem m\u1ee5c 6.1)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"735\" height=\"653\" class=\"wp-image-54973\" src=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2022\/10\/word-image-77.png\" srcset=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2022\/10\/word-image-77.png 735w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2022\/10\/word-image-77-300x267.png 300w\" sizes=\"auto, (max-width: 735px) 100vw, 735px\" \/><\/p>\n<p><em>H\u00ecnh \u1ea3nh mang t\u00ednh ch\u1ea5t tham kh\u1ea3o, thu\u1ed1c ch\u01b0a l\u01b0u h\u00e0nh t\u1ea1i Vi\u1ec7t Nam.<\/em><\/p>\n<h2><span class=\"ez-toc-section\" id=\"3-video-by-pharmog\"><\/span>3. Video by Pharmog:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><strong>[VIDEO D\u01af\u1ee2C L\u00dd]<\/strong><\/p>\n<p>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;<\/p>\n<p>\u25ba K\u1ecbch B\u1ea3n: PharmogTeam<\/p>\n<p>\u25ba Youtube: https:\/\/www.youtube.com\/c\/pharmog<\/p>\n<p>\u25ba Facebook: https:\/\/www.facebook.com\/pharmog\/<\/p>\n<p>\u25ba Group : H\u1ed9i nh\u1eefng ng\u01b0\u1eddi m\u00ea d\u01b0\u1ee3c l\u00fd<\/p>\n<p>\u25ba Instagram : https:\/\/www.instagram.com\/pharmogvn\/<\/p>\n<p>\u25ba Website: pharmog.com<\/p>\n<h2><span class=\"ez-toc-section\" id=\"4-ung-dung-lam-sang\"><\/span>4. \u1ee8ng d\u1ee5ng l\u00e2m s\u00e0ng:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"41-chi-dinh\"><\/span>4.1. Ch\u1ec9 \u0111\u1ecbnh:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Tr\u00e1nh thai.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"42-lieu-dung-%e2%80%93-cach-dung\"><\/span>4.2. Li\u1ec1u d\u00f9ng &#8211; C\u00e1ch d\u00f9ng:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><strong><em>C\u00e1ch d\u00f9ng<\/em><\/strong> :<\/p>\n<p>Ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u00f3 th\u1ec3 t\u1ef1 \u0111\u01b0a V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel v\u00e0o \u00e2m \u0111\u1ea1o. Th\u1ea7y thu\u1ed1c c\u1ea7n h\u01b0\u1edbng d\u1eabn ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u00e1ch \u0111\u1eb7t V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel v\u00e0o v\u00e0 c\u00e1ch l\u1ea5y ra.<\/p>\n<p><em>C\u00e1ch b\u1eaft \u0111\u1ea7u d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel<\/em><\/p>\n<p><em>Kh\u00f4ng d\u00f9ng thu\u1ed1c tr\u00e1nh thai c\u00f3 ch\u1ee9a n\u1ed9i ti\u1ebft t\u1ed1 n\u00e0o trong chu k\u1ef3 kinh tr\u01b0\u1edbc \u0111\u00f3<\/em><\/p>\n<p>V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel ph\u1ea3i \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o ng\u00e0y th\u1ee9 nh\u1ea5t c\u1ee7a chu k\u1ef3 kinh t\u1ef1 nhi\u00ean c\u1ee7a ng\u01b0\u1eddi ph\u1ee5 n\u1eef (t\u1ee9c l\u00e0 ng\u00e0y \u0111\u1ea7u ti\u00ean c\u00f3 kinh). C\u00f3 th\u1ec3 b\u1eaft \u0111\u1ea7u v\u00e0o ng\u00e0y 2-5, nh\u01b0ng trong chu k\u1ef3 \u0111\u1ea7u, ph\u01b0\u01a1ng ph\u00e1p m\u00e0ng ng\u0103n \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o d\u00f9ng th\u00eam trong 7 ng\u00e0y \u0111\u1ea7u d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel.<\/p>\n<p><em>Chuy\u1ec3n t\u1eeb bi\u1ec7n ph\u00e1p tr\u00e1nh thai ch\u1ee9a n\u1ed9i ti\u1ebft t\u1ed1 ph\u1ed1i h\u1ee3p<\/em><\/p>\n<p>Ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u1ea7n \u0111\u1eb7t V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel ch\u1eadm nh\u1ea5t v\u00e0o ng\u00e0y ngay sau nh\u1eefng ng\u00e0y t\u1ea1m ngh\u1ec9 u\u1ed1ng vi\u00ean thu\u1ed1c, t\u1ea1m ngh\u1ec9 d\u00f9ng mi\u1ebfng d\u00e1n ho\u1eb7c ngay sau nh\u1eefng ng\u00e0y u\u1ed1ng vi\u00ean gi\u1ea3 d\u01b0\u1ee3c nh\u01b0 h\u01b0\u1edbng d\u1eabn c\u1ee7a bi\u1ec7n ph\u00e1p tr\u00e1nh thai ch\u1ee9a n\u1ed9i ti\u1ebft ph\u1ed1i h\u1ee3p \u0111ang d\u00f9ng.<\/p>\n<p>N\u1ebfu ng\u01b0\u1eddi ph\u1ee5 n\u1eef \u0111\u00e3 d\u00f9ng ph\u01b0\u01a1ng ph\u00e1p tr\u01b0\u1edbc \u0111\u00e2y \u0111\u1ec1u \u0111\u1eb7n v\u00e0 \u0111\u00fang h\u01b0\u1edbng d\u1eabn, v\u00e0 n\u1ebfu ch\u1eafc ch\u1eafn kh\u00f4ng mang thai th\u00ec c\u00f3 th\u1ec3 chuy\u1ec3n \u0111\u1ed5i t\u1eeb bi\u1ec7n ph\u00e1p tr\u00e1nh thai ch\u1ee9a n\u1ed9i ti\u1ebft t\u1ed1 ph\u1ed1i h\u1ee3p tr\u01b0\u1edbc \u0111\u00e2y v\u00e0o b\u1ea5t k\u1ef3 ng\u00e0y n\u00e0o c\u1ee7a chu k\u1ef3 kinh.<\/p>\n<p>Kho\u1ea3ng th\u1eddi gian kh\u00f4ng c\u00f3 n\u1ed9i ti\u1ebft c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p tr\u01b0\u1edbc kh\u00f4ng bao gi\u1edd \u0111\u01b0\u1ee3c v\u01b0\u1ee3t qu\u00e1 th\u1eddi gian khuy\u1ebfn c\u00e1o.<\/p>\n<p><em>Chuy\u1ec3n \u0111\u1ed5i t\u1eeb m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ch\u1ec9 d\u00f9ng progestagen (vi\u00ean tr\u00e1nh thai, que c\u1ea5y ho\u1eb7c thu\u1ed1c ti\u00eam) ho\u1eb7c t\u1eeb v\u00f2ng \u0111\u1eb7t t\u1eed cung gi\u1ea3i ph\u00f3ng progestagen (IUS: intrauterine system).<\/em><\/p>\n<p>Ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u00f3 th\u1ec3 chuy\u1ec3n sang d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel v\u00e0o b\u1ea5t k\u1ef3 ng\u00e0y n\u00e0o c\u1ee7a v\u1ec9 thu\u1ed1c ch\u1ec9 ch\u1ee9a progestagen (ho\u1eb7c t\u1eeb ng\u00e0y r\u00fat que c\u1ea5y ho\u1eb7c th\u00e1o v\u00f2ng \u0111\u1eb7t t\u1eed cung ho\u1eb7c n\u1ebfu l\u00e0 thu\u1ed1c ti\u00eam th\u00ec k\u1ec3 t\u1eeb ng\u00e0y c\u1ea7n ti\u00eam li\u1ec1u ti\u1ebfp theo), nh\u01b0ng trong t\u1ea5t c\u1ea3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p, c\u1ea7n d\u00f9ng th\u00eam ph\u01b0\u01a1ng ph\u00e1p m\u00e0ng ng\u0103n trong 7 ng\u00e0y \u0111\u1ea7u ti\u00ean d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel.<\/p>\n<p><em>Sau khi s\u1ea3y thai \u1edf ba th\u00e1ng \u0111\u1ea7u thai k\u1ef3<\/em><\/p>\n<p>Ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u00f3 th\u1ec3 b\u1eaft \u0111\u1ea7u s\u1eed d\u1ee5ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel ngay l\u1eadp t\u1ee9c m\u00e0 kh\u00f4ng c\u1ea7n d\u00f9ng th\u00eam bi\u1ec7n ph\u00e1p tr\u00e1nh thai n\u00e0o. N\u1ebfu ch\u01b0a mu\u1ed1n d\u00f9ng ngay, ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u1ea7n theo h\u01b0\u1edbng d\u1eabn \u0111\u1ed1i v\u1edbi ;Kh\u00f4ng d\u00f9ng thu\u1ed1c tr\u00e1nh thai c\u00f3 ch\u1ee9a n\u1ed9i ti\u1ebft t\u1ed1 n\u00e0o trong chu k\u1ef3 kinh tr\u01b0\u1edbc \u0111\u00f3;. Trong th\u1eddi gian n\u00e0y, ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u1ea7n d\u00f9ng m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai kh\u00e1c.<\/p>\n<p><em>Sau khi sinh con ho\u1eb7c s\u1ea3y thai \u1edf ba th\u00e1ng th\u1ee9 hai c\u1ee7a thai k\u1ef3<\/em><\/p>\n<p>V\u1edbi ph\u1ee5 n\u1eef \u0111ang cho con b\u00fa, xem m\u1ee5c Thai k\u1ef3 v\u00e0 cho con b\u00fa.<\/p>\n<p>N\u00ean khuy\u00ean ng\u01b0\u1eddi ph\u1ee5 n\u1eef b\u1eaft \u0111\u1ea7u d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel v\u00e0o tu\u1ea7n th\u1ee9 t\u01b0 sau khi sinh ho\u1eb7c s\u1ea3y thai \u1edf ba th\u00e1ng th\u1ee9 hai c\u1ee7a thai k\u1ef3. Khi d\u00f9ng mu\u1ed9n h\u01a1n, ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u1ea7n d\u00f9ng th\u00eam ph\u01b0\u01a1ng ph\u00e1p m\u00e0ng ng\u0103n trong 7 ng\u00e0y \u0111\u1ea7u ti\u00ean d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel. Tuy nhi\u00ean, n\u1ebfu \u0111\u00e3 giao h\u1ee3p, c\u1ea7n ph\u1ea3i \u0111\u1ea3m b\u1ea3o kh\u00f4ng mang thai ho\u1eb7c ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u1ea7n \u0111\u1ee3i \u0111\u1ebfn khi c\u00f3 kinh tr\u1edf l\u1ea1i tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel.<\/p>\n<p><strong><em>Li\u1ec1u d\u00f9ng:<\/em><\/strong><\/p>\n<p>\u0110\u1ec3 \u0111\u1ea1t \u0111\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 tr\u00e1nh thai, V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel ph\u1ea3i \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 \u0111\u00e3 h\u01b0\u1edbng d\u1eabn.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<h3><span class=\"ez-toc-section\" id=\"43-chong-chi-dinh\"><\/span>4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel khi c\u00f3 b\u1ea5t k\u1ef3 t\u00ecnh hu\u1ed1ng n\u00e0o \u0111\u01b0\u1ee3c li\u1ec7t k\u00ea d\u01b0\u1edbi \u0111\u00e2y. N\u1ebfu c\u00f3 t\u00ecnh hu\u1ed1ng n\u00e0o xu\u1ea5t hi\u1ec7n l\u1ea7n \u0111\u1ea7u ti\u00ean trong khi d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel, c\u1ea7n ph\u1ea3i l\u1ea5y ra ngay.<\/p>\n<p>Hi\u1ec7n c\u00f3 ho\u1eb7c c\u00f3 ti\u1ec1n s\u1eed huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch, c\u00f3 k\u00e8m ho\u1eb7c kh\u00f4ng ngh\u1ebdn m\u1ea1ch ph\u1ed5i.<\/p>\n<p>Hi\u1ec7n c\u00f3 ho\u1eb7c c\u00f3 ti\u1ec1n s\u1eed huy\u1ebft kh\u1ed1i \u0111\u1ed9ng m\u1ea1ch (v\u00ed d\u1ee5 tai bi\u1ebfn m\u1ea1ch n\u00e3o, nh\u1ed3i m\u00e1u c\u01a1 tim) ho\u1eb7c ti\u1ec1n tri\u1ec7u huy\u1ebft kh\u1ed1i (v\u00ed d\u1ee5 \u0111au th\u1eaft ng\u1ef1c ho\u1eb7c c\u01a1n thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 tho\u00e1ng qua).<\/p>\n<p>\u0110\u00e3 bi\u1ebft c\u00f3 nh\u1eefng y\u1ebfu t\u1ed1 c\u00f3 khuynh h\u01b0\u1edbng g\u00e2y huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch ho\u1eb7c \u0111\u1ed9ng m\u1ea1ch, c\u00f3 ho\u1eb7c kh\u00f4ng li\u00ean quan \u0111\u1ebfn di truy\u1ec1n nh\u01b0 c\u00f3 kh\u00e1ng Protein C ho\u1ea1t h\u00f3a (APC: Activated Protein C), thi\u1ebfu antithrombin III, thi\u1ebfu protein C, thi\u1ebfu protein S, t\u0103ng homocystein trong m\u00e1u v\u00e0 c\u00e1c kh\u00e1ng th\u1ec3 kh\u00e1ng phospholipid (kh\u00e1ng th\u1ec3 kh\u00e1ng cardiolipin, lupus ch\u1ed1ng \u0111\u00f4ng).<\/p>\n<p>Ti\u1ec1n s\u1eed \u0111au n\u1eeda \u0111\u1ea7u k\u00e8m tri\u1ec7u ch\u1ee9ng th\u1ea7n kinh \u1ed5.<\/p>\n<p>\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u00f3 t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u.<\/p>\n<p>Hi\u1ec7n c\u00f3 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 nhi\u1ec1u v\u00e0 n\u1eb7ng \u0111\u1ed1i v\u1edbi huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch v\u00e0 \u0111\u1ed9ng m\u1ea1ch c\u0169ng c\u00f3 th\u1ec3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh.<\/p>\n<p>Vi\u00eam t\u1ee5y ho\u1eb7c ti\u1ec1n s\u1eed vi\u00eam t\u1ee5y k\u00e8m t\u0103ng triglycerid huy\u1ebft n\u1eb7ng.<\/p>\n<p>Hi\u1ec7n c\u00f3 ho\u1eb7c c\u00f3 ti\u1ec1n s\u1eed b\u1ec7nh gan n\u1eb7ng l\u00e0m cho c\u00e1c th\u00f4ng s\u1ed1 ch\u1ee9c n\u0103ng gan kh\u00f4ng tr\u1edf l\u1ea1i \u0111\u01b0\u1ee3c b\u00ecnh th\u01b0\u1eddng.<\/p>\n<p>Hi\u1ec7n c\u00f3 ho\u1eb7c c\u00f3 ti\u1ec1n s\u1eed u gan (l\u00e0nh t\u00ednh ho\u1eb7c \u00e1c t\u00ednh).<\/p>\n<p>\u0110\u00e3 bi\u1ebft r\u00f5 ho\u1eb7c nghi ng\u1edd u \u00e1c t\u00ednh c\u00e1c c\u01a1 quan sinh d\u1ee5c ho\u1eb7c v\u00fa, ch\u1ecbu \u1ea3nh h\u01b0\u1edfng c\u1ee7a c\u00e1c steroid gi\u1edbi t\u00ednh.<\/p>\n<p>Xu\u1ea5t huy\u1ebft \u00e2m \u0111\u1ea1o ch\u01b0a ch\u1ea9n \u0111o\u00e1n ra nguy\u00ean nh\u00e2n.<\/p>\n<p>Bi\u1ebft c\u00f3 thai ho\u1eb7c nghi ng\u1edd c\u00f3 thai.<\/p>\n<p>T\u0103ng m\u1eabn c\u1ea3m v\u1edbi ho\u1ea1t ch\u1ea5t ho\u1eb7c v\u1edbi b\u1ea5t k\u1ef3 t\u00e1 d\u01b0\u1ee3c n\u00e0o c\u1ee7a V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"44-than-trong\"><\/span>4.4 Th\u1eadn tr\u1ecdng:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><em>C\u1ea3nh b\u00e1o<\/em><\/p>\n<p>N\u1ebfu c\u00f3 b\u1ea5t k\u1ef3 y\u1ebfu t\u1ed1 nguy c\u01a1 n\u00e0o \u0111\u01b0\u1ee3c n\u00eau d\u01b0\u1edbi \u0111\u00e2y, l\u1ee3i \u00edch c\u1ee7a vi\u1ec7c d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel c\u1ea7n \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc so v\u1edbi nguy c\u01a1 c\u00f3 th\u1ec3 x\u1ea3y ra \u0111\u1ed1i v\u1edbi t\u1eebng ng\u01b0\u1eddi ph\u1ee5 n\u1eef v\u00e0 ph\u1ea3i b\u00e0n b\u1ea1c v\u1edbi ng\u01b0\u1eddi ph\u1ee5 n\u1eef tr\u01b0\u1edbc khi quy\u1ebft \u0111\u1ecbnh d\u00f9ng. Khi b\u1ecb t\u0103ng n\u1eb7ng, k\u1ecbch ph\u00e1t ho\u1eb7c l\u1ea7n \u0111\u1ea7u xu\u1ea5t hi\u1ec7n b\u1ea5t k\u1ef3 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 n\u00e0y, ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u1ea7n \u0111\u1ebfn th\u1ea7y thu\u1ed1c \u0111\u1ec3 \u0111\u01b0\u1ee3c kh\u00e1m. Khi \u0111\u00f3, th\u1ea7y thu\u1ed1c c\u1ea7n quy\u1ebft \u0111\u1ecbnh xem c\u00f3 c\u1ea7n ng\u1eebng d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel kh\u00f4ng. T\u1ea5t c\u1ea3 c\u00e1c s\u1ed1 li\u1ec7u tr\u00ecnh b\u00e0y d\u01b0\u1edbi \u0111\u00e2y d\u1ef1a v\u00e0o t\u00e0i li\u1ec7u d\u1ecbch t\u1ec5 thu \u0111\u01b0\u1ee3c khi d\u00f9ng thu\u1ed1c tr\u00e1nh thai ph\u1ed1i h\u1ee3p d\u1ea1ng u\u1ed1ng (COC: combined oral contraceptive). Ch\u01b0a c\u00f3 t\u00e0i li\u1ec7u d\u1ecbch t\u1ec5 c\u1ee7a vi\u1ec7c d\u00f9ng \u0111\u01b0\u1eddng \u00e2m \u0111\u1ea1o \u0111\u1ed1i v\u1edbi c\u00e1c n\u1ed9i ti\u1ebft, nh\u01b0ng c\u00e1c c\u1ea3nh b\u00e1o n\u00e0y c\u0169ng c\u00f3 th\u1ec3 \u00e1p d\u1ee5ng khi d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel.<\/p>\n<p><em>R\u1ed1i lo\u1ea1n tu\u1ea7n ho\u00e0n<\/em><\/p>\n<p>Nh\u1eefng nghi\u00ean c\u1ee9u d\u1ecbch t\u1ec5 cho th\u1ea5y c\u00f3 s\u1ef1 li\u00ean quan gi\u1eefa d\u00f9ng COC v\u00e0 nguy c\u01a1 huy\u1ebft kh\u1ed1i \u0111\u1ed9ng m\u1ea1ch v\u00e0 t\u0129nh m\u1ea1ch, v\u00e0 c\u00e1c b\u1ec7nh huy\u1ebft kh\u1ed1i ngh\u1ebdn m\u1ea1ch nh\u01b0 nh\u1ed3i m\u00e1u c\u01a1 tim, c\u01a1n \u0111\u1ed9t qu\u1ef5, huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u, v\u00e0 ngh\u1ebdn m\u1ea1ch ph\u1ed5i. Nh\u1eefng tai bi\u1ebfn n\u00e0y hi\u1ebfm khi x\u1ea3y ra.<\/p>\n<p>D\u00f9ng b\u1ea5t k\u1ef3 thu\u1ed1c tr\u00e1nh thai ph\u1ed1i h\u1ee3p d\u1ea1ng u\u1ed1ng n\u00e0o \u0111\u1ec1u c\u00f3 nguy c\u01a1 t\u0103ng b\u1ec7nh huy\u1ebft kh\u1ed1i ngh\u1ebdn t\u0129nh m\u1ea1ch (VTE: venous thrombo-embolism) so v\u1edbi kh\u00f4ng d\u00f9ng. Nguy c\u01a1 b\u1ec7nh VTE cao nh\u1ea5t trong n\u0103m \u0111\u1ea7u ti\u00ean \u1edf ng\u01b0\u1eddi n\u1eef ch\u01b0a t\u1eebng d\u00f9ng thu\u1ed1c tr\u00e1nh thai ph\u1ed1i h\u1ee3p d\u1ea1ng u\u1ed1ng. S\u1ef1 t\u0103ng nguy c\u01a1 c\u1ee7a b\u1ec7nh VTE n\u00e0y v\u1eabn th\u1ea5p h\u01a1n nguy c\u01a1 VTE \u1edf ng\u01b0\u1eddi mang thai, \u0111\u00e3 x\u00e1c \u0111\u1ecbnh l\u00e0 6 tr\u01b0\u1eddng h\u1ee3p VTE cho 10 000 ng\u01b0\u1eddi mang thai. B\u1ec7nh VTE g\u00e2y ch\u1ebft \u1edf 1-2% c\u00e1c tr\u01b0\u1eddng h\u1ee3p.<\/p>\n<p>C\u00f2n ch\u01b0a bi\u1ebft V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel \u1ea3nh h\u01b0\u1edfng nh\u01b0 th\u1ebf n\u00e0o \u0111\u1ebfn nguy c\u01a1 n\u00e0y so v\u1edbi c\u00e1c thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft ph\u1ed1i h\u1ee3p kh\u00e1c.<\/p>\n<p>C\u1ef1c k\u1ef3 hi\u1ebfm l\u00e0, b\u1ec7nh huy\u1ebft kh\u1ed1i \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o x\u1ea3y ra \u1edf c\u00e1c m\u1ea1ch m\u00e1u kh\u00e1c, nh\u01b0 \u0111\u1ed9ng m\u1ea1ch v\u00e0 t\u0129nh m\u1ea1ch gan, m\u1ea1c treo, th\u1eadn, n\u00e3o ho\u1eb7c v\u00f5ng m\u1ea1c \u1edf ng\u01b0\u1eddi d\u00f9ng COC. C\u00f2n ch\u01b0a c\u00f3 s\u1ef1 nh\u1ea5t tr\u00ed xem c\u00e1c tai bi\u1ebfn n\u00e0y x\u1ea3y ra c\u00f3 ph\u1ea3i l\u00e0 do d\u00f9ng COC kh\u00f4ng.<\/p>\n<p>C\u00e1c tri\u1ec7u ch\u1ee9ng huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch v\u00e0 \u0111\u1ed9ng m\u1ea1ch c\u00f3 th\u1ec3 bao g\u1ed3m: \u0111au v\u00e0\/ho\u1eb7c s\u01b0ng m\u1ed9t b\u00ean ch\u00e2n b\u1ea5t th\u01b0\u1eddng; \u0111au d\u1eef d\u1ed9i \u0111\u1ed9t ng\u1ed9t \u1edf ng\u1ef1c, c\u00f3 ho\u1eb7c kh\u00f4ng lan ra c\u00e1nh tay tr\u00e1i; kh\u00f3 th\u1edf \u0111\u1ed9t ng\u1ed9t; c\u01a1n ho \u0111\u1ed9t ng\u1ed9t; \u0111au \u0111\u1ea7u d\u1eef d\u1ed9i k\u00e9o d\u00e0i b\u1ea5t th\u01b0\u1eddng; th\u1ecb l\u1ef1c \u0111\u1ed9t ng\u1ed9t gi\u1ea3m m\u1ed9t ph\u1ea7n ho\u1eb7c m\u1ea5t ho\u00e0n to\u00e0n; nh\u00ecn m\u1ed9t ho\u00e1 hai (song th\u1ecb); n\u00f3i l\u00edu l\u01b0\u1ee1i ho\u1eb7c kh\u00f4ng n\u00f3i \u0111\u01b0\u1ee3c; ch\u00f3ng m\u1eb7t; tru\u1ef5 m\u1ea1ch c\u00f3 ho\u1eb7c kh\u00f4ng k\u00e8m c\u01a1n \u0111\u1ed9ng kinh \u1ed5; ng\u01b0\u1eddi y\u1ebfu ho\u1eb7c t\u00ea r\u1ea5t n\u1eb7ng \u0111\u1ed9t ng\u1ed9t \u1edf m\u1ed9t b\u00ean ho\u1eb7c m\u1ed9t ph\u1ea7n c\u01a1 th\u1ec3; r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng; h\u1ed9i ch\u1ee9ng b\u1ee5ng c\u1ea5p.<\/p>\n<p><em>Nguy c\u01a1 huy\u1ebft kh\u1ed1i ngh\u1ebdn t\u0129nh m\u1ea1ch t\u0103ng khi:<\/em><\/p>\n<p>Tu\u1ed5i cao<\/p>\n<p>C\u00f3 ti\u1ec1n s\u1eed gia \u0111\u00ecnh (b\u1ec7nh huy\u1ebft kh\u1ed1i ngh\u1ebdn t\u0129nh m\u1ea1ch \u0111\u00e3 t\u1eebng c\u00f3 \u1edf anh ch\u1ecb em ho\u1eb7c b\u1ed1 m\u1eb9 \u1edf tu\u1ed5i c\u00f2n t\u01b0\u01a1ng \u0111\u1ed1i tr\u1ebb). N\u1ebfu nghi l\u00e0 c\u00f3 b\u1ea9m ch\u1ea5t di truy\u1ec1n, ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u1ea7n tham kh\u1ea3o \u00fd ki\u1ebfn c\u1ee7a chuy\u00ean gia tr\u01b0\u1edbc khi quy\u1ebft \u0111\u1ecbnh d\u00f9ng b\u1ea5t k\u1ef3 thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft n\u00e0o.<\/p>\n<p>Ph\u1ea3i b\u1ea5t \u0111\u1ed9ng k\u00e9o d\u00e0i, ph\u1eabu thu\u1eadt l\u1edbn, b\u1ea5t k\u1ef3 ph\u1eabu thu\u1eadt n\u00e0o \u1edf ch\u00e2n ho\u1eb7c ch\u1ea5n th\u01b0\u01a1ng l\u1edbn. Trong nh\u1eefng t\u00ecnh hu\u1ed1ng n\u00e0y, n\u00ean ng\u1eebng d\u00f9ng (trong tr\u01b0\u1eddng h\u1ee3p ph\u1eabu thu\u1eadt ch\u01b0\u01a1ng tr\u00ecnh, \u00edt nh\u1ea5t l\u00e0 4 tu\u1ea7n tr\u01b0\u1edbc \u0111\u00f3) v\u00e0 ch\u1ec9 \u0111\u01b0\u1ee3c d\u00f9ng l\u1ea1i 2 tu\u1ea7n sau khi \u0111\u00e3 v\u1eadn \u0111\u1ed9ng l\u1ea1i ho\u00e0n to\u00e0n.<\/p>\n<p>Ng\u01b0\u1eddi b\u00e9o ph\u00ec (ch\u1ec9 s\u1ed1 kh\u1ed1i l\u01b0\u1ee3ng c\u01a1 th\u1ec3 tr\u00ean 30 kg\/m2).<\/p>\n<p>v\u00e0 c\u00f3 th\u1ec3 v\u1edbi c\u1ea3 vi\u00eam t\u0129nh m\u1ea1ch huy\u1ebft kh\u1ed1i n\u00f4ng v\u00e0 gi\u00e3n t\u0129nh m\u1ea1ch. Ch\u01b0a c\u00f3 s\u1ef1 th\u1ed1ng nh\u1ea5t v\u1ec1 vai tr\u00f2 c\u00f3 th\u1ec3 c\u00f3 c\u1ee7a nh\u1eefng t\u00ecnh tr\u1ea1ng n\u00e0y trong c\u00e1c nguy\u00ean nh\u00e2n d\u1eabn t\u1edbi huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch.<\/p>\n<p><em>Nguy c\u01a1 bi\u1ebfn ch\u1ee9ng huy\u1ebft kh\u1ed1i ngh\u1ebdn \u0111\u1ed9ng m\u1ea1ch t\u0103ng khi:<\/em><\/p>\n<p>Tu\u1ed5i cao<\/p>\n<p>H\u00fat thu\u1ed1c (h\u00fat thu\u1ed1c c\u00e0ng n\u1eb7ng v\u00e0 tu\u1ed5i c\u00e0ng cao th\u00ec nguy c\u01a1 c\u00e0ng t\u0103ng, \u0111\u1eb7c bi\u1ec7t l\u00e0 ph\u1ee5 n\u1eef tr\u00ean 35 tu\u1ed5i);<\/p>\n<p>R\u1ed1i lo\u1ea1n lipoprotein huy\u1ebft;<\/p>\n<p>Ng\u01b0\u1eddi b\u00e9o ph\u00ec (ch\u1ec9 s\u1ed1 kh\u1ed1i l\u01b0\u1ee3ng c\u01a1 th\u1ec3 tr\u00ean 30 kg\/m2);<\/p>\n<p>T\u0103ng huy\u1ebft \u00e1p;<\/p>\n<p>\u0110au nh\u1ee9c n\u1eeda \u0111\u1ea7u;<\/p>\n<p>B\u1ec7nh van tim;<\/p>\n<p>Rung nh\u0129;<\/p>\n<p>C\u00f3 ti\u1ec1n s\u1eed gia \u0111\u00ecnh (b\u1ec7nh huy\u1ebft kh\u1ed1i \u0111\u1ed9ng m\u1ea1ch \u0111\u00e3 t\u1eebng c\u00f3 \u1edf anh ch\u1ecb em ho\u1eb7c b\u1ed1 m\u1eb9 \u1edf tu\u1ed5i c\u00f2n t\u01b0\u01a1ng \u0111\u1ed1i tr\u1ebb). N\u1ebfu nghi l\u00e0 c\u00f3 b\u1ea9m ch\u1ea5t di truy\u1ec1n, ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u1ea7n tham kh\u1ea3o \u00fd ki\u1ebfn c\u1ee7a chuy\u00ean gia tr\u01b0\u1edbc khi quy\u1ebft \u0111\u1ecbnh d\u00f9ng b\u1ea5t k\u1ef3 thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft n\u00e0o.<\/p>\n<p>C\u00e1c y\u1ebfu t\u1ed1 h\u00f3a sinh c\u00f3 th\u1ec3 l\u00e0 ch\u1ec9 th\u1ecb c\u1ee7a b\u1ea9m ch\u1ea5t di truy\u1ec1n ho\u1eb7c m\u1eafc ph\u1ea3i \u0111\u1ed1i v\u1edbi huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch ho\u1eb7c \u0111\u1ed9ng m\u1ea1ch, bao g\u1ed3m: c\u00f3 kh\u00e1ng Protein C ho\u1ea1t h\u00f3a, t\u0103ng homocystein trong m\u00e1u, thi\u1ebfu antithrombin III, thi\u1ebfu protein C, thi\u1ebfu protein S, c\u00e1c kh\u00e1ng th\u1ec3 kh\u00e1ng phospholipid (kh\u00e1ng th\u1ec3 kh\u00e1ng cardiolipin, luput ch\u1ed1ng \u0111\u00f4ng).<\/p>\n<p>C\u00e1c b\u1ec7nh kh\u00e1c c\u0169ng c\u00f3 li\u00ean quan \u0111\u1ebfn tai bi\u1ebfn tu\u1ea7n ho\u00e0n bao g\u1ed3m \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, luput ban \u0111\u1ecf to\u00e0n th\u00e2n, h\u1ed9i ch\u1ee9ng ur\u00ea huy\u1ebft do tan m\u00e1u, v\u00e0 b\u1ec7nh vi\u00eam ru\u1ed9t m\u1ea1n t\u00ednh (nh\u01b0 b\u1ec7nh Crohn&#8217;s ho\u1eb7c vi\u00eam k\u1ebft tr\u00e0ng c\u00f3 lo\u00e9t) v\u00e0 b\u1ec7nh t\u1ebf b\u00e0o h\u00ecnh li\u1ec1m.<\/p>\n<p>C\u1ea7n ch\u00fa \u00fd \u0111\u1ebfn nguy c\u01a1 huy\u1ebft kh\u1ed1i ngh\u1ebdn m\u1ea1ch t\u0103ng trong khi sinh v\u00e0 h\u1eadu s\u1ea3n.<\/p>\n<p>T\u1ea7n s\u1ed1 v\u00e0 m\u1ee9c \u0111\u1ed9 \u0111au n\u1eeda \u0111\u1ea7u t\u0103ng khi d\u00f9ng thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft (c\u00f3 th\u1ec3 l\u00e0 ti\u1ec1n tri\u1ec7u c\u1ee7a m\u1ed9t tai bi\u1ebfn m\u1ea1ch m\u00e1u n\u00e3o) c\u00f3 th\u1ec3 l\u00e0 l\u00fd do c\u1ea7n ng\u1eebng d\u00f9ng ngay thu\u1ed1c tr\u00e1nh thai hormon.<\/p>\n<p>Khi xem x\u00e9t gi\u1eefa nguy c\u01a1\/l\u1ee3i \u00edch, th\u1ea7y thu\u1ed1c c\u1ea7n ch\u00fa \u00fd r\u1eb1ng, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb \u0111\u00fang c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m nguy c\u01a1 huy\u1ebft kh\u1ed1i v\u00e0 r\u1eb1ng nguy c\u01a1 huy\u1ebft kh\u1ed1i do thai ngh\u00e9n c\u00f2n cao h\u01a1n nguy c\u01a1 huy\u1ebft kh\u1ed1i ph\u1ed1i h\u1ee3p v\u1edbi d\u00f9ng thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft.<\/p>\n<p><em>C\u00e1c u<\/em><\/p>\n<p>Y\u1ebfu t\u1ed1 nguy c\u01a1 quan tr\u1ecdng nh\u1ea5t g\u00e2y ung th\u01b0 c\u1ed5 t\u1eed cung l\u00e0 nhi\u1ec5m dai d\u1eb3ng vi r\u00fat papilloma c\u1ee7a ng\u01b0\u1eddi (HPV: human papilloma virus). Nh\u1eefng nghi\u00ean c\u1ee9u d\u1ecbch t\u1ec5 ch\u1ec9 r\u1eb1ng d\u00f9ng l\u00e2u d\u00e0i COC g\u00f3p ph\u1ea7n l\u00e0m t\u0103ng nguy c\u01a1 n\u00e0y, nh\u01b0ng c\u00f2n ch\u01b0a ch\u1eafc ch\u1eafn v\u1ec1 m\u1ee9c \u0111\u1ed9 nguy c\u01a1 m\u00e0 m\u1ee9c \u0111\u1ed9 nguy c\u01a1 n\u00e0y c\u00f3 th\u1ec3 quy k\u1ebft cho nh\u1eefng y\u1ebfu t\u1ed1 nhi\u1ec5u, nh\u01b0 t\u0103ng t\u1ea7m so\u00e1t ung th\u01b0 c\u1ed5 t\u1eed cung, v\u00e0 s\u1ef1 kh\u00e1c nhau v\u1ec1 h\u00e0nh vi t\u00ecnh d\u1ee5c bao g\u1ed3m c\u1ea3 d\u00f9ng c\u00e1c bi\u1ec7n ph\u00e1p tr\u00e1nh thai b\u1eb1ng m\u00e0ng ng\u0103n, ho\u1eb7c c\u00f3 s\u1ef1 ph\u1ed1i h\u1ee3p nguy\u00ean nh\u00e2n. C\u00f2n ch\u01b0a bi\u1ebft r\u00f5 t\u00e1c d\u1ee5ng n\u00e0y c\u00f3 li\u00ean quan \u0111\u1ebfn V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel nh\u01b0 th\u1ebf n\u00e0o.<\/p>\n<p>Ph\u00e2n t\u00edch 54 nghi\u00ean c\u1ee9u d\u1ecbch t\u1ec5 cho th\u1ea5y nguy c\u01a1 t\u01b0\u01a1ng \u0111\u1ed1i h\u01a1i t\u0103ng (RR = 1,24) v\u1ec1 ung th\u01b0 v\u00fa \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u1edf ph\u1ee5 n\u1eef hi\u1ec7n \u0111ang d\u00f9ng COC. Nguy c\u01a1 cao n\u00e0y m\u1ea5t d\u1ea7n trong 10 n\u0103m sau khi ng\u1eebng d\u00f9ng COC. V\u00ec ung th\u01b0 v\u00fa r\u1ea5t hi\u1ebfm \u1edf ph\u1ee5 n\u1eef d\u01b0\u1edbi 40 tu\u1ed5i, n\u00ean s\u1ed1 ung th\u01b0 v\u00fa t\u0103ng \u1edf ng\u01b0\u1eddi hi\u1ec7n \u0111ang d\u00f9ng v\u00e0 m\u1edbi ng\u1eebng d\u00f9ng COC t\u01b0\u01a1ng \u0111\u1ed1i nh\u1ecf so v\u1edbi nguy c\u01a1 chung v\u1ec1 ung th\u01b0 v\u00fa. Ung th\u01b0 v\u00fa \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u1edf ng\u01b0\u1eddi \u0111\u00e3 t\u1eebng d\u00f9ng, c\u00f3 khuynh h\u01b0\u1edbng ti\u1ebfn tri\u1ec3n l\u00e2m s\u00e0ng k\u00e9m h\u01a1n ung th\u01b0 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u1edf ng\u01b0\u1eddi ch\u01b0a t\u1eebng d\u00f9ng. Ki\u1ec3u c\u00e1ch quan s\u00e1t th\u1ea5y nguy c\u01a1 t\u0103ng c\u00f3 th\u1ec3 l\u00e0 do \u0111\u00e3 ch\u1ea9n \u0111o\u00e1n ung th\u01b0 v\u00fa s\u1edbm h\u01a1n \u1edf ng\u01b0\u1eddi d\u00f9ng COC, ho\u1eb7c do t\u00e1c d\u1ee5ng sinh h\u1ecdc c\u1ee7a COC ho\u1eb7c do k\u1ebft h\u1ee3p c\u1ea3 hai.<\/p>\n<p>Trong r\u1ea5t hi\u1ebfm c\u00e1c tr\u01b0\u1eddng h\u1ee3p, u gan l\u00e0nh t\u00ednh, v\u00e0 th\u1eadm ch\u00ed c\u00f2n hi\u1ebfm h\u01a1n, u gan \u00e1c t\u00ednh \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf ng\u01b0\u1eddi d\u00f9ng COC. Trong tr\u01b0\u1eddng h\u1ee3p \u0111\u1eb7c bi\u1ec7t, c\u00e1c u n\u00e0y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn xu\u1ea5t huy\u1ebft trong b\u1ee5ng \u0111e d\u1ecda \u0111\u1ebfn t\u00ednh m\u1ea1ng. Do \u0111\u00f3, u gan c\u1ea7n \u0111\u01b0\u1ee3c coi nh\u01b0 ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t khi c\u00f3 \u0111au v\u00f9ng b\u1ee5ng tr\u00ean n\u1eb7ng, gan to ho\u1eb7c c\u00f3 d\u1ea5u hi\u1ec7u xu\u1ea5t huy\u1ebft trong b\u1ee5ng x\u1ea3y ra \u1edf ph\u1ee5 n\u1eef d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel.<\/p>\n<p><em>C\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00e1c<\/em><\/p>\n<p>Ph\u1ee5 n\u1eef t\u0103ng triglycerid huy\u1ebft, ho\u1eb7c c\u00f3 ti\u1ec1n s\u1eed gia \u0111\u00ecnh t\u0103ng triglycerid huy\u1ebft c\u00f3 th\u1ec3 b\u1ecb t\u0103ng nguy c\u01a1 vi\u00eam t\u1ee5y khi d\u00f9ng thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft.<\/p>\n<p>M\u1eb7c d\u1ea7u huy\u1ebft \u00e1p t\u0103ng nh\u1eb9 \u0111\u00e3 c\u00f3 b\u00e1o c\u00e1o \u1edf nhi\u1ec1u ph\u1ee5 n\u1eef d\u00f9ng thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft, nh\u01b0ng hi\u1ebfm khi t\u0103ng c\u00f3 \u00fd ngh\u0129a l\u00e2m s\u00e0ng. M\u1ed1i t\u01b0\u01a1ng quan ch\u1eafc ch\u1eafn gi\u1eefa d\u00f9ng thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft v\u00e0 t\u0103ng huy\u1ebft \u00e1p l\u00e2m s\u00e0ng v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh. Tuy nhi\u00ean, n\u1ebfu th\u1ea5y c\u00f3 t\u0103ng huy\u1ebft \u00e1p c\u00f3 \u00fd ngh\u0129a l\u00e2m s\u00e0ng ph\u00e1t tri\u1ec3n trong khi d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel, th\u00ec th\u1ea7y thu\u1ed1c n\u00ean th\u1eadn tr\u1ecdng c\u1ea7n ng\u1eebng d\u00f9ng v\u00f2ng v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p. Khi th\u1ea5y ph\u00f9 h\u1ee3p, c\u00f3 th\u1ec3 d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel tr\u1edf l\u1ea1i n\u1ebfu huy\u1ebft \u00e1p tr\u1edf v\u1ec1 b\u00ecnh th\u01b0\u1eddng do \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p.<\/p>\n<p>Nh\u1eefng tr\u01b0\u1eddng h\u1ee3p sau \u0111\u00e2y \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o l\u00e0 c\u00f3 th\u1ec3 x\u1ea3y ra ho\u1eb7c c\u00f3 \u1ea3nh h\u01b0\u1edfng x\u1ea5u \u0111\u1ebfn c\u1ea3 ng\u01b0\u1eddi c\u00f3 thai v\u00e0 trong th\u1eddi gian d\u00f9ng thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft, nh\u01b0ng b\u1eb1ng ch\u1ee9ng c\u00f3 li\u00ean quan \u0111\u1ebfn vi\u1ec7c s\u1eed d\u1ee5ng v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c k\u1ebft lu\u1eadn: v\u00e0ng da v\u00e0\/ho\u1eb7c ng\u1ee9a do \u1ee9 m\u1eadt; s\u1ecfi m\u1eadt; lo\u1ea1n chuy\u1ec3n h\u00f3a porphyrin; lupus ban \u0111\u1ecf to\u00e0n th\u00e2n; h\u1ed9i ch\u1ee9ng ur\u00ea huy\u1ebft do tan m\u00e1u; m\u00faa gi\u1eadt Sydenham; Herpes thai ngh\u00e9n; gi\u1ea3m th\u00ednh l\u1ef1c do x\u01a1 c\u1ee9ng tai; ph\u00f9 m\u1ea1ch (di truy\u1ec1n).<\/p>\n<p>R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng gan c\u1ea5p ho\u1eb7c m\u1ea1n t\u00ednh c\u00f3 th\u1ec3 c\u1ea7n ng\u1eebng d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel cho \u0111\u1ebfn khi c\u00e1c th\u00f4ng s\u1ed1 v\u1ec1 ch\u1ee9c n\u0103ng gan tr\u1edf l\u1ea1i b\u00ecnh th\u01b0\u1eddng. C\u1ea7n ng\u1eebng d\u00f9ng v\u00f2ng khi b\u1ecb t\u00e1i ph\u00e1t v\u00e0ng da \u1ee9 m\u1eadt v\u00e0\/ho\u1eb7c ng\u1ee9a do \u1ee9 m\u1eadt \u0111\u00e3 t\u1eebng x\u1ea3y ra l\u1ea7n \u0111\u1ea7u ti\u00ean trong khi c\u00f3 thai ho\u1eb7c d\u00f9ng steroid sinh d\u1ee5c tr\u01b0\u1edbc \u0111\u00e2y.<\/p>\n<p>M\u1eb7c d\u00f9 c\u00e1c estrogen v\u00e0 progestagen c\u00f3 th\u1ec3 c\u00f3 t\u00e1c d\u1ee5ng tr\u00ean s\u1ef1 kh\u00e1ng insulin ngo\u1ea1i vi v\u00e0 s\u1ef1 dung n\u1ea1p glucose, nh\u01b0ng ch\u01b0a c\u00f3 b\u1eb1ng ch\u1ee9ng c\u1ea7n ph\u1ea3i thay \u0111\u1ed5i ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb \u1edf ng\u01b0\u1eddi \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng d\u00f9ng thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft. Tuy nhi\u00ean, ph\u1ee5 n\u1eef \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i c\u1ea9n th\u1eadn trong khi d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel, \u0111\u1eb7c bi\u1ec7t l\u00e0 trong nh\u1eefng th\u00e1ng d\u00f9ng \u0111\u1ea7u ti\u00ean.<\/p>\n<p>S\u1ef1 n\u1eb7ng th\u00eam b\u1ec7nh Crohn v\u00e0 vi\u00eam k\u1ebft tr\u00e0ng c\u00f3 lo\u00e9t \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o khi d\u00f9ng thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft.<\/p>\n<p>N\u00e1m da \u0111\u00f4i khi c\u00f3 th\u1ec3 x\u1ea3y ra, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf ph\u1ee5 n\u1eef c\u00f3 ti\u1ec1n s\u1eed n\u00e1m da khi c\u00f3 thai. Ph\u1ee5 n\u1eef c\u00f3 khuynh h\u01b0\u1edbng n\u00e1m da c\u1ea7n tr\u00e1nh ti\u1ebfp x\u00fac v\u1edbi m\u1eb7t tr\u1eddi ho\u1eb7c tia t\u1eed ngo\u1ea1i khi d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel.<\/p>\n<p>N\u1ebfu ng\u01b0\u1eddi n\u1eef c\u00f3 m\u1ed9t trong c\u00e1c t\u00ecnh tr\u1ea1ng sau, c\u00f3 th\u1ec3 kh\u00f4ng th\u1ec3 \u0111\u01b0a V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel v\u00e0o \u0111\u00fang ho\u1eb7c c\u00f3 th\u1ec3 l\u00e0m m\u1ea5t v\u00f2ng: sa c\u1ed5 t\u1eed cung, tho\u00e1t v\u1ecb b\u00e0ng quang v\u00e0\/ho\u1eb7c sa tr\u1ef1c tr\u00e0ng, t\u00e1o b\u00f3n n\u1eb7ng ho\u1eb7c m\u1ea1n t\u00ednh.<\/p>\n<p>C\u00f3 b\u00e1o c\u00e1o nh\u01b0ng r\u1ea5t hi\u1ebfm l\u00e0 tr\u01b0\u1eddng h\u1ee3p v\u00f4 \u00fd \u0111\u01b0a V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel v\u00e0o ni\u1ec7u \u0111\u1ea1o, c\u00f3 th\u1ec3 l\u00ean \u0111\u1ebfn b\u00e0ng quang. Do \u0111\u00f3, c\u1ea7n ch\u00fa \u00fd vi\u1ec7c \u0111\u1eb7t kh\u00f4ng \u0111\u00fang v\u1ecb tr\u00ed khi ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t trong tr\u01b0\u1eddng h\u1ee3p c\u00f3 tri\u1ec7u ch\u1ee9ng vi\u00eam b\u00e0ng quang.<\/p>\n<p>Trong khi d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel, ng\u01b0\u1eddi ph\u1ee5 n\u1eef \u0111\u00f4i khi c\u00f3 th\u1ec3 b\u1ecb vi\u00eam \u00e2m \u0111\u1ea1o. Nh\u01b0ng kh\u00f4ng th\u1ea5y hi\u1ec7u qu\u1ea3 c\u1ee7a V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi \u0111i\u1ec1u tr\u1ecb vi\u00eam \u00e2m \u0111\u1ea1o, c\u0169ng kh\u00f4ng th\u1ea5y d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn \u0111i\u1ec1u tr\u1ecb vi\u00eam \u00e2m \u0111\u1ea1o.<\/p>\n<p>C\u00f3 b\u00e1o c\u00e1o nh\u01b0ng r\u1ea5t hi\u1ebfm tr\u01b0\u1eddng h\u1ee3p v\u00f2ng d\u00ednh v\u00e0o m\u00f4 \u00e2m \u0111\u1ea1o, c\u1ea7n l\u1ea5y ra b\u1edfi c\u00e1n b\u1ed9 y t\u1ebf.<\/p>\n<p><em>X\u00e9t nghi\u1ec7m\/t\u01b0 v\u1ea5n y h\u1ecdc<\/em><\/p>\n<p>Tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u d\u00f9ng ho\u1eb7c d\u00f9ng l\u1ea1i V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel, c\u1ea7n l\u1ea5y b\u1ec7nh s\u1eed y khoa \u0111\u1ea7y \u0111\u1ee7 (k\u1ec3 c\u1ea3 ti\u1ec1n s\u1eed y khoa gia \u0111\u00ecnh) v\u00e0 ph\u1ea3i lo\u1ea1i tr\u1eeb \u0111ang mang thai. C\u1ea7n ti\u1ebfn h\u00e0nh \u0111o huy\u1ebft \u00e1p v\u00e0 kh\u00e1m th\u1ef1c th\u1ec3 theo \u0111\u1ecbnh h\u01b0\u1edbng c\u00e1c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u00e0 c\u1ea3nh b\u00e1o. Ng\u01b0\u1eddi ph\u1ee5 n\u1eef c\u1ea7n \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u0111\u1ecdc k\u1ef9 t\u1edd h\u01b0\u1edbng d\u1eabn trong bao b\u00ec v\u00e0 ph\u1ea3i theo \u0111\u00fang h\u01b0\u1edbng d\u1eabn. T\u1ea7n s\u1ed1 v\u00e0 b\u1ea3n ch\u1ea5t c\u00e1c ki\u1ec3m tra \u0111\u1ecbnh k\u1ef3 ti\u1ebfp theo c\u1ea7n d\u1ef1a v\u00e0o th\u1ef1c t\u1ebf kh\u00e1m l\u00e2m s\u00e0ng v\u00e0 ph\u1ea3i ph\u00f9 h\u1ee3p v\u1edbi m\u1ed7i ng\u01b0\u1eddi n\u1eef.<\/p>\n<p>C\u1ea7n khuy\u1ebfn c\u00e1o \u0111\u1ec3 ng\u01b0\u1eddi n\u1eef bi\u1ebft r\u1eb1ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel kh\u00f4ng b\u1ea3o v\u1ec7 ch\u1ed1ng nhi\u1ec5m HIV (AIDS) v\u00e0 c\u00e1c b\u1ec7nh l\u00e2y \u0111\u01b0\u1eddng t\u00ecnh d\u1ee5c kh\u00e1c.<\/p>\n<p><em>Gi\u1ea3m hi\u1ec7u qu\u1ea3<\/em><\/p>\n<p>Hi\u1ec7u qu\u1ea3 c\u1ee7a V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel c\u00f3 th\u1ec3 gi\u1ea3m trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng tu\u00e2n th\u1ee7 (M\u1ee5c Kh\u00f4ng tu\u00e2n th\u1ee7 ph\u00e1c \u0111\u1ed3 \u0111\u00e3 khuy\u00ean c\u00e1o), ho\u1eb7c d\u00f9ng c\u00f9ng v\u1edbi thu\u1ed1c kh\u00e1c (M\u1ee5c T\u01b0\u01a1ng t\u00e1c).<\/p>\n<p><em>Ki\u1ec3m so\u00e1t chu k\u1ef3 kinh gi\u1ea3m<\/em><\/p>\n<p>Ra m\u00e1u kh\u00f4ng \u0111\u1ec1u (th\u1ea5m gi\u1ecdt ho\u1eb7c xu\u1ea5t huy\u1ebft) c\u00f3 th\u1ec3 x\u1ea3y ra khi d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel. N\u1ebfu ra m\u00e1u kh\u00f4ng \u0111\u1ec1u x\u1ea3y ra sau nh\u1eefng chu k\u1ef3 kinh \u0111\u1ec1u \u0111\u1eb7n tr\u01b0\u1edbc \u0111\u00e2y, trong khi V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel \u0111\u00e3 \u0111\u01b0\u1ee3c d\u00f9ng theo ph\u00e1c \u0111\u1ed3 \u0111\u00e3 khuy\u1ebfn c\u00e1o, c\u1ea7n ph\u1ea3i ch\u00fa \u00fd \u0111\u1ebfn nguy\u00ean nh\u00e2n kh\u00f4ng ph\u1ea3i do n\u1ed9i ti\u1ebft, v\u00e0 c\u1ea7n c\u00f3 bi\u1ec7n ph\u00e1p ch\u1ea9n \u0111o\u00e1n th\u00edch h\u1ee3p \u0111\u1ec3 lo\u1ea1i b\u1ecf u \u00e1c t\u00ednh ho\u1eb7c c\u00f3 thai. Nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y c\u00f3 th\u1ec3 ph\u1ea3i n\u1ea1o b\u1ecf.<\/p>\n<p>\u1ede m\u1ed9t v\u00e0i ph\u1ee5 n\u1eef, c\u00f3 th\u1ec3 kh\u00f4ng th\u1ea5y m\u00e1u ra trong th\u1eddi gian kh\u00f4ng c\u00f3 v\u00f2ng. N\u1ebfu V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel \u0111\u00e3 \u0111\u01b0\u1ee3c d\u00f9ng theo h\u01b0\u1edbng d\u1eabn, kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng ng\u01b0\u1eddi ph\u1ee5 n\u1eef \u0111\u00e3 c\u00f3 thai. Tuy nhi\u00ean, n\u1ebfu V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u00fang theo h\u01b0\u1edbng d\u1eabn tr\u01b0\u1edbc khi kh\u00f4ng th\u1ea5y k\u1ef3 kinh l\u1ea7n th\u1ee9 nh\u1ea5t ho\u1eb7c n\u1ebfu hai k\u1ef3 kinh \u0111\u1ec1u kh\u00f4ng th\u1ea5y, kh\u1ea3 n\u0103ng c\u00f3 thai ph\u1ea3i \u0111\u01b0\u1ee3c lo\u1ea1i tr\u1eeb tr\u01b0\u1edbc khi ti\u1ebfp t\u1ee5c d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel.<\/p>\n<p><strong>T\u00e1c \u0111\u1ed9ng c\u1ee7a thu\u1ed1c tr\u00ean ng\u01b0\u1eddi l\u00e1i xe v\u00e0 v\u1eadn h\u00e0nh m\u00e1y m\u00f3c.<\/strong><\/p>\n<p>C\u0103n c\u1ee9 v\u00e0o d\u01b0\u1ee3c l\u1ef1c h\u1ecdc, th\u00ec V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel kh\u00f4ng c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn kh\u1ea3 n\u0103ng l\u00e1i xe v\u00e0 v\u1eadn h\u00e0nh m\u00e1y m\u00f3c.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<h3><span class=\"ez-toc-section\" id=\"45-su-dung-cho-phu-nu-co-thai-va-cho-con-bu\"><\/span>4.5 S\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 cho con b\u00fa:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><em>X\u1ebfp h\u1ea1ng c\u1ea3nh b\u00e1o<\/em><\/p>\n<p>AU TGA pregnancy category: B3<\/p>\n<p>US FDA pregnancy category: X<\/p>\n<p><em>Th\u1eddi k\u1ef3 mang thai:<\/em><\/p>\n<p>Kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel trong khi mang thai. N\u1ebfu x\u1ea3y ra c\u00f3 thai m\u00e0 V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel v\u1eabn \u1edf trong \u00e2m \u0111\u1ea1o, ph\u1ea3i l\u1ea5y v\u00f2ng ra ngay.<\/p>\n<p><em>Kh\u1ea3 n\u0103ng sinh s\u1ea3n:<\/em><\/p>\n<p>V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 tr\u00e1nh thai. N\u1ebfu ng\u01b0\u1eddi ph\u1ee5 n\u1eef mu\u1ed1n ng\u1eebng s\u1eed d\u1ee5ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel v\u00ec mu\u1ed1n mang thai th\u00ec n\u00ean ch\u1edd cho \u0111\u1ebfn khi c\u00f3 kinh nguy\u1ec7t t\u1ef1 nhi\u00ean tr\u01b0\u1edbc khi th\u1ee5 thai v\u00ec \u0111i\u1ec1u n\u00e0y s\u1ebd gi\u00fap ng\u01b0\u1eddi ph\u1ee5 n\u1eef t\u00ednh to\u00e1n th\u1eddi \u0111i\u1ec3m sinh con.<\/p>\n<p><em>Th\u1eddi k\u1ef3 cho con b\u00fa:<\/em><\/p>\n<p>Vi\u1ec7c ti\u1ebft s\u1eefa c\u00f3 th\u1ec3 b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi estrogen, v\u00ec thu\u1ed1c c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng v\u00e0 l\u00e0m thay \u0111\u1ed5i th\u00e0nh ph\u1ea7n c\u1ee7a s\u1eefa. Do \u0111\u00f3 n\u00f3i chung, ch\u1ec9 khuy\u1ebfn c\u00e1o d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel cho ng\u01b0\u1eddi m\u1eb9 \u0111\u00e3 cai s\u1eefa ho\u00e0n to\u00e0n. M\u1ed9t l\u01b0\u1ee3ng nh\u1ecf steroid tr\u00e1nh thai v\u00e0\/ho\u1eb7c c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a c\u1ee7a ch\u00fang c\u00f3 th\u1ec3 ti\u1ebft v\u00e0o s\u1eefa, nh\u01b0ng kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng c\u00f3 th\u1ec3 g\u00e2y t\u00e1c h\u1ea1i cho s\u1ee9c kho\u1ebb c\u1ee7a tr\u1ebb.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"46-tac-dung-khong-mong-muon-adr\"><\/span>4.6 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n (ADR):<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>C\u00e1c t\u00e1c d\u1ee5ng b\u1ea5t l\u1ee3i \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf ng\u01b0\u1eddi d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel \u0111\u01b0\u1ee3c li\u1ec7t k\u00ea \u1edf b\u1ea3ng d\u01b0\u1edbi \u0111\u00e2y. Thu\u1eadt ng\u1eef th\u00edch h\u1ee3p nh\u1ea5t MeDRA \u0111\u1ec3 m\u00f4 t\u1ea3 t\u00e1c d\u1ee5ng b\u1ea5t l\u1ee3i \u0111\u00e3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng.<\/p>\n<table>\n<tbody>\n<tr>\n<td><strong>Lo\u1ea1i h\u1ec7 c\u01a1 quan<\/strong><\/td>\n<td><strong>Th\u01b0\u1eddng g\u1eb7p \u2265 1\/100<\/strong><\/td>\n<td><strong>\u00cdt g\u1eb7p &lt; 1\/100, \u2265 1\/1000<\/strong><\/td>\n<td><strong>Hi\u1ebfm g\u1eb7p &lt; 1\/1000, \u2265 1\/10000<\/strong><\/td>\n<td><strong>Sau l\u01b0u h\u00e0nh1<\/strong><\/td>\n<\/tr>\n<tr>\n<td>Nhi\u1ec5m tr\u00f9ng v\u00e0 nhi\u1ec5m k\u00fd sinh tr\u00f9ng<\/td>\n<td>Nhi\u1ec5m tr\u00f9ng \u00e2m \u0111\u1ea1o<\/td>\n<td>Vi\u00eam c\u1ed5 t\u1eed cung, Vi\u00eam b\u00e0ng quang, Nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u<\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>R\u1ed1i lo\u1ea1n h\u1ec7 mi\u1ec5n d\u1ecbch<\/td>\n<td><\/td>\n<td><\/td>\n<td><\/td>\n<td>T\u0103ng nh\u1ea1y c\u1ea3m<\/td>\n<\/tr>\n<tr>\n<td>R\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a v\u00e0 dinh d\u01b0\u1ee1ng<\/td>\n<td><\/td>\n<td>Th\u00e8m \u0103n t\u0103ng<\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>R\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n<\/td>\n<td>Tr\u1ea7m c\u1ea3m, Gi\u1ea3m t\u00ecnh d\u1ee5c<\/td>\n<td>Thay \u0111\u1ed5i t\u00e2m tr\u1ea1ng<\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>R\u1ed1i lo\u1ea1n h\u1ec7 th\u1ea7n kinh<\/td>\n<td>Nh\u1ee9c \u0111\u1ea7u, \u0110au n\u1eeda \u0111\u1ea7u<\/td>\n<td>Ch\u00f3ng m\u1eb7t hoa m\u1eaft, Gi\u1ea3m c\u1ea3m gi\u00e1c<\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>R\u1ed1i lo\u1ea1n m\u1eaft<\/td>\n<td><\/td>\n<td>R\u1ed1i lo\u1ea1n th\u1ecb gi\u00e1c<\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>R\u1ed1i lo\u1ea1n m\u1ea1ch<\/td>\n<td><\/td>\n<td>N\u00f3ng \u0111\u1ecf b\u1eebng<\/td>\n<td>Thuy\u00ean t\u1eafc t\u0129nh m\u1ea1ch huy\u1ebft kh\u1ed1i3<\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>R\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a<\/td>\n<td>\u0110au b\u1ee5ng, Bu\u1ed3n n\u00f4n<\/td>\n<td>Ch\u01b0\u1edbng b\u1ee5ng, Ti\u00eau ch\u1ea3y, N\u00f4n, T\u00e1o b\u00f3n<\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>R\u1ed1i lo\u1ea1n da v\u00e0 m\u00f4 d\u01b0\u1edbi da<\/td>\n<td>Tr\u1ee9ng c\u00e1<\/td>\n<td>R\u1ee5ng t\u00f3c, Eczema, Ng\u1ee9a, Ban da<\/td>\n<td><\/td>\n<td>M\u00e0y \u0111ay<\/td>\n<\/tr>\n<tr>\n<td>R\u1ed1i lo\u1ea1n c\u01a1 x\u01b0\u01a1ng v\u00e0 m\u00f4 li\u00ean k\u1ebft<\/td>\n<td><\/td>\n<td>\u0110au l\u01b0ng, Co th\u1eaft c\u01a1, \u0110au c\u00e1c \u0111\u1ea7u chi<\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>R\u1ed1i lo\u1ea1n th\u1eadn v\u00e0 ti\u1ebft ni\u1ec7u<\/td>\n<td><\/td>\n<td>Kh\u00f3 \u0111\u00e1i, \u0110\u00e1i g\u1ea5p, \u0110\u00e1i r\u1eaft<\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>R\u1ed1i lo\u1ea1n v\u00fa v\u00e0 h\u1ec7 sinh s\u1ea3n<\/td>\n<td>C\u0103ng v\u00fa, Ng\u1ee9a sinh d\u1ee5c n\u1eef, Th\u1ed1ng kinh, \u0110au v\u00f9ng ch\u1eadu h\u00f4ng, T\u0103ng ti\u1ebft d\u1ecbch \u00e2m \u0111\u1ea1o<\/td>\n<td>V\u00f4 kinh, Kh\u00f3 ch\u1ecbu \u1edf v\u00fa, V\u00fa to, Kh\u1ed1i u v\u00fa, Polyp c\u1ed5 t\u1eed cung, Ch\u1ea3y m\u00e1u khi giao h\u1ee3p, Giao h\u1ee3p \u0111au, L\u1ed9n c\u1ed5 t\u1eed cung, B\u1ec7nh u x\u01a1 nang v\u00fa, Rong kinh, Rong huy\u1ebft, \u0111au v\u00f9ng ch\u1eadu, tri\u1ec7u ch\u1ee9ng ti\u1ec1n kinh nguy\u1ec7t, co th\u1eaft t\u1eed cung, n\u00f3ng r\u00e1t \u00e2m \u0111\u1ea1o, H\u00f4i \u00e2m \u0111\u1ea1o, \u0111au \u00e2m \u0111\u1ea1o, kh\u00f3 ch\u1ecbu \u00e2m h\u1ed9, kh\u00f4 \u00e2m h\u1ed9<\/td>\n<td><\/td>\n<td>R\u1ed1i lo\u1ea1n d\u01b0\u01a1ng v\u1eadt2<\/td>\n<\/tr>\n<tr>\n<td>R\u1ed1i lo\u1ea1n to\u00e0n th\u00e2n v\u00e0 t\u1ea1i ch\u1ed7<\/td>\n<td><\/td>\n<td>M\u1ec7t m\u1ecfi, d\u1ec5 b\u1ecb k\u00edch th\u00edch, Kh\u00f3 \u1edf, Ph\u00f9, C\u1ea3m gi\u00e1c c\u00f3 v\u1eadt l\u1ea1<\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Kh\u1ea3o s\u00e1t \u0111i\u1ec1u tra<\/td>\n<td>T\u0103ng c\u00e2n<\/td>\n<td>Huy\u1ebft \u00e1p t\u0103ng<\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>T\u1ed5n th\u01b0\u01a1ng, \u0110\u1ed9c h\u1ea1i v\u00e0 Qui tr\u00ecnh ph\u1ee9c t\u1ea1p<\/td>\n<td>B\u1ea5t ti\u1ec7n khi s\u1eed d\u1ee5ng, D\u1ee5ng c\u1ee5 tr\u00e1nh thai \u00e2m \u0111\u1ea1o b\u1ecb \u0111\u1ea9y ra<\/td>\n<td>D\u1ee5ng c\u1ee5 tr\u00e1nh thai ph\u1ee9c t\u1ea1p, G\u1eaby d\u1ee5ng c\u1ee5<\/td>\n<td><\/td>\n<td><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>(1). Li\u1ec7t k\u00ea c\u00e1c tai bi\u1ebfn l\u00e0 d\u1ef1a v\u00e0o b\u00e1o c\u00e1o t\u1ef1 nhi\u00ean n\u00ean kh\u00f4ng th\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c t\u1ea7n s\u1ed1<\/p>\n<p>(2). R\u1ed1i lo\u1ea1n d\u01b0\u01a1ng v\u1eadt bao g\u1ed3m c\u00e1c b\u00e1o c\u00e1o l\u00e0;c\u00f3 ph\u1ea3n \u1ee9ng t\u1ea1i ch\u1ed7 tr\u00ean d\u01b0\u01a1ng v\u1eadt<\/p>\n<p>(3). D\u1eef li\u1ec7u nghi\u00ean c\u1ee9u quan s\u00e1t \u0111o\u00e0n h\u1ec7: &gt; 1\/10000 \u0111\u1ebfn &lt; 1\/1000 ph\u1ee5 n\u1eef n\u0103m.<\/p>\n<p><em>Th\u00f4ng b\u00e1o cho B\u00e1c s\u0129 nh\u1eefng t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n g\u1eb7p ph\u1ea3i khi s\u1eed d\u1ee5ng thu\u1ed1c.<\/em><\/p>\n<p><em><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/em><\/p>\n<h3><span class=\"ez-toc-section\" id=\"47-huong-dan-cach-xu-tri-adr\"><\/span>4.7 H\u01b0\u1edbng d\u1eabn c\u00e1ch x\u1eed tr\u00ed ADR:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Ng\u1eebng s\u1eed d\u1ee5ng thu\u1ed1c. V\u1edbi c\u00e1c ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i nh\u1eb9, th\u01b0\u1eddng ch\u1ec9 c\u1ea7n ng\u1eebng thu\u1ed1c. Tr\u01b0\u1eddng h\u1ee3p m\u1eabn c\u1ea3m n\u1eb7ng ho\u1eb7c ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng, c\u1ea7n ti\u1ebfn h\u00e0nh \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 (gi\u1eef tho\u00e1ng kh\u00ed v\u00e0 d\u00f9ng epinephrin, th\u1edf oxygen, d\u00f9ng kh\u00e1ng histamin, corticoid&#8230;).<\/p>\n<h3><span class=\"ez-toc-section\" id=\"48-tuong-tac-voi-cac-thuoc-khac\"><\/span>4.8 T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><em>T\u01b0\u01a1ng t\u00e1c gi\u1eefa c\u00e1c thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft v\u00e0 c\u00e1c thu\u1ed1c kh\u00e1c c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ra m\u00e1u v\u00e0\/ho\u1eb7c kh\u00f4ng c\u00f2n t\u00e1c d\u1ee5ng tr\u00e1nh thai. Trong t\u00e0i li\u1ec7u \u0111\u00e3 c\u00f3 c\u00e1c b\u00e1o c\u00e1o t\u01b0\u01a1ng t\u00e1c sau \u0111\u00e2y:<\/em><\/p>\n<p>S\u1ef1 chuy\u1ec3n h\u00f3a \u1edf gan: T\u01b0\u01a1ng t\u00e1c c\u00f3 th\u1ec3 x\u1ea3y ra v\u1edbi c\u00e1c thu\u1ed1c g\u00e2y c\u1ea3m \u1ee9ng enzym microsom, g\u00e2y ra t\u0103ng thanh th\u1ea3i hormon sinh d\u1ee5c (nh\u01b0 phenytoin, phenobarbital, primidon, carbamazepin, rifampicin, v\u00e0 c\u0169ng c\u00f3 th\u1ec3 c\u1ea3 oxcarbazepin, topiramat, felbamat, ritonavir, griseofulvin v\u00e0 c\u00e1c s\u1ea3n ph\u1ea9m c\u00f3 ch\u1ee9a St. John&#8217;s wort).<\/p>\n<p>Ng\u01b0\u1eddi ph\u1ee5 n\u1eef khi \u0111i\u1ec1u tr\u1ecb v\u1edbi b\u1ea5t k\u1ef3 lo\u1ea1i n\u00e0o trong c\u00e1c thu\u1ed1c n\u00e0y c\u1ea7n t\u1ea1m th\u1eddi d\u00f9ng th\u00eam ph\u01b0\u01a1ng ph\u00e1p m\u00e0ng ng\u0103n c\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel ho\u1eb7c ch\u1ecdn m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p tr\u00e1nh thai kh\u00e1c. V\u1edbi c\u00e1c thu\u1ed1c g\u00e2y c\u1ea3m \u1ee9ng enzym microsom gan, n\u00ean d\u00f9ng ph\u01b0\u01a1ng ph\u00e1p m\u00e0ng ng\u0103n trong th\u1eddi gian \u0111\u1ed3ng th\u1eddi d\u00f9ng thu\u1ed1c v\u00e0 28 ng\u00e0y sau khi ng\u1eebng thu\u1ed1c.<\/p>\n<p>N\u1ebfu d\u00f9ng thu\u1ed1c \u0111\u1ed3ng th\u1eddi k\u00e9o d\u00e0i qu\u00e1 3 tu\u1ea7n c\u1ee7a chu k\u1ef3 c\u00f3 v\u00f2ng, c\u1ea7n \u0111\u01b0a ngay v\u00f2ng m\u1edbi v\u00e0o m\u00e0 kh\u00f4ng c\u00f3 kho\u1ea3ng th\u1eddi gian kh\u00f4ng c\u00f3 v\u00f2ng nh\u01b0 b\u00ecnh th\u01b0\u1eddng.<\/p>\n<p>Th\u1ea5t b\u1ea1i tr\u00e1nh thai \u0111\u01b0\u1ee3c c\u0169ng \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o khi d\u00f9ng kh\u00e1ng sinh, nh\u01b0 c\u00e1c penicillin v\u00e0 c\u00e1c tetracyclin. C\u01a1 ch\u1ebf c\u1ee7a t\u00e1c d\u1ee5ng n\u00e0y v\u1eabn c\u00f2n ch\u01b0a bi\u1ebft r\u00f5. Trong m\u1ed9t nghi\u00ean c\u1ee9u t\u01b0\u01a1ng t\u00e1c d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc, u\u1ed1ng amoxicillin (875 mg, ng\u00e0y 2 l\u1ea7n) ho\u1eb7c doxycyclin (200 mg v\u00e0o ng\u00e0y 1, ti\u1ebfp theo m\u1ed7i ng\u00e0y 100 mg) trong 10 ng\u00e0y trong khi d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel kh\u00f4ng th\u1ea5y \u1ea3nh h\u01b0\u1edfng c\u00f3 \u00fd ngh\u0129a \u0111\u1ebfn d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a etonogestrel v\u00e0 ethinylestradiol. Ph\u1ee5 n\u1eef khi d\u00f9ng kh\u00e1ng sinh (tr\u1eeb amoxicillin v\u00e0 doxycyclin) c\u1ea7n d\u00f9ng ph\u01b0\u01a1ng ph\u00e1p m\u00e0ng ng\u0103n th\u00eam 7 ng\u00e0y sau khi ng\u1eebng thu\u1ed1c. N\u1ebfu d\u00f9ng thu\u1ed1c \u0111\u1ed3ng th\u1eddi qu\u00e1 3 tu\u1ea7n c\u1ee7a chu k\u1ef3 c\u00f3 v\u00f2ng, c\u1ea7n \u0111\u01b0a ngay m\u1ed9t v\u00f2ng m\u1edbi v\u00e0o m\u00e0 kh\u00f4ng c\u00f3 kho\u1ea3ng th\u1eddi gian kh\u00f4ng c\u00f3 v\u00f2ng nh\u01b0 b\u00ecnh th\u01b0\u1eddng.<\/p>\n<p>D\u1ef1a v\u00e0o nghi\u00ean c\u1ee9u d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc, c\u00e1c thu\u1ed1c kh\u00e1ng n\u1ea5m v\u00e0 di\u1ec7t tinh tr\u00f9ng d\u00f9ng \u0111\u01b0\u1eddng \u00e2m \u0111\u1ea1o kh\u00f4ng c\u00f3 khuynh h\u01b0\u1edbng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn hi\u1ec7u qu\u1ea3 tr\u00e1nh thai v\u00e0 an to\u00e0n c\u1ee7a V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel. Trong khi d\u00f9ng \u0111\u1ed3ng th\u1eddi vi\u00ean thu\u1ed1c tr\u1ee9ng kh\u00e1ng n\u1ea5m, c\u01a1 h\u1ed9i v\u00f2ng b\u1ecb g\u1eaby c\u00f3 cao h\u01a1n \u0111\u00f4i ch\u00fat (xem M\u1ee5c V\u00f2ng b\u1ecb g\u1eaby).<\/p>\n<p>Thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft c\u00f3 th\u1ec3 can thi\u1ec7p v\u00e0o chuy\u1ec3n ho\u00e1 c\u1ee7a c\u00e1c thu\u1ed1c kh\u00e1c. V\u00ec th\u1ebf, n\u1ed3ng \u0111\u1ed9 trong huy\u1ebft t\u01b0\u01a1ng v\u00e0 m\u00f4 c\u00f3 th\u1ec3 t\u0103ng (nh\u01b0 ciclosporin) ho\u1eb7c gi\u1ea3m (nh\u01b0 lamotrigin).<\/p>\n<p>Vi\u1ec7c h\u01b0\u1edbng d\u1eabn k\u00ea \u0111\u01a1n d\u00f9ng thu\u1ed1c \u0111\u1ed3ng th\u1eddi c\u1ea7n ph\u1ea3i tra c\u1ee9u \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh c\u00e1c t\u01b0\u01a1ng t\u00e1c.<\/p>\n<p><em>C\u00e1c x\u00e9t nghi\u1ec7m<\/em><\/p>\n<p>D\u00f9ng c\u00e1c steroid tr\u00e1nh thai c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn k\u1ebft qu\u1ea3 c\u1ee7a m\u1ed9t s\u1ed1 x\u00e9t nghi\u1ec7m, k\u1ec3 c\u1ea3 c\u00e1c th\u00f4ng s\u1ed1 h\u00f3a sinh c\u1ee7a ch\u1ee9c n\u0103ng gan, tuy\u1ebfn gi\u00e1p, th\u1eadn v\u00e0 th\u01b0\u1ee3ng th\u1eadn, h\u00e0m l\u01b0\u1ee3ng trong huy\u1ebft t\u01b0\u01a1ng c\u1ee7a c\u00e1c protein mang (nh\u01b0 globulin li\u00ean k\u1ebft corticosteroid, globulin li\u00ean k\u1ebft hormon gi\u1edbi t\u00ednh), c\u00e1c th\u00e0nh ph\u1ea7n c\u1ee7a lipid\/lipoprotein, c\u00e1c th\u00f4ng s\u1ed1 chuy\u1ec3n h\u00f3a carbohydrat v\u00e0 c\u00e1c th\u00f4ng s\u1ed1 \u0111\u00f4ng m\u00e1u v\u00e0 ti\u00eau fibrin. Nh\u1eefng thay \u0111\u1ed5i n\u00e0y th\u01b0\u1eddng v\u1eabn trong ph\u1ea1m vi gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng.<\/p>\n<p><em>T\u01b0\u01a1ng t\u00e1c v\u1edbi b\u0103ng v\u1ec7 sinh d\u00f9ng trong \u00e2m \u0111\u1ea1o<\/em><\/p>\n<p>Nh\u1eefng nghi\u00ean c\u1ee9u d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc ch\u1ec9 r\u1eb1ng, d\u00f9ng b\u0103ng v\u1ec7 sinh kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng tr\u00ean s\u1ef1 h\u1ea5p thu v\u00e0o c\u01a1 th\u1ec3 c\u1ee7a c\u00e1c hormon do V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel gi\u1ea3i ph\u00f3ng ra. R\u1ea5t hi\u1ebfm tr\u01b0\u1eddng h\u1ee3p V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel c\u00f3 th\u1ec3 b\u1ecb \u0111\u1ea9y ra trong khi th\u00e1o b\u0103ng v\u1ec7 sinh ra (xem h\u01b0\u1edbng d\u1eabn trong ;L\u00e0m gi n\u1ebfu v\u00f2ng nh\u1ea5t th\u1eddi ra ngo\u00e0i \u00e2m \u0111\u1ea1o; \u1edf m\u1ee5c Kh\u00f4ng tu\u00e2n th\u1ee7 ph\u00e1c \u0111\u1ed3 \u0111\u00e3 khuy\u00ean c\u00e1o).<\/p>\n<h3><span class=\"ez-toc-section\" id=\"49-qua-lieu-va-xu-tri\"><\/span>4.9 Qu\u00e1 li\u1ec1u v\u00e0 x\u1eed tr\u00ed:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Ch\u01b0a th\u1ea5y c\u00f3 b\u00e1o c\u00e1o v\u1ec1 t\u00e1c d\u1ee5ng \u0111\u1ed9c h\u1ea1i nghi\u00eam tr\u1ecdng do qu\u00e1 li\u1ec1u thu\u1ed1c tr\u00e1nh thai n\u1ed9i ti\u1ebft. C\u00e1c tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 x\u1ea3y ra trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y l\u00e0 bu\u1ed3n n\u00f4n, n\u00f4n v\u00e0, \u1edf c\u00e1c c\u00f4 g\u00e1i tr\u1ebb, xu\u1ea5t huy\u1ebft t\u1eed cung nh\u1eb9. Ch\u01b0a c\u00f3 thu\u1ed1c gi\u1ea3i \u0111\u1ed9c v\u00e0 c\u1ea7n \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<h2><span class=\"ez-toc-section\" id=\"5-co-che-tac-dung-cua-thuoc\"><\/span>5. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c :<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"51-duoc-luc-hoc\"><\/span>5.1. D\u01b0\u1ee3c l\u1ef1c h\u1ecdc:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Nh\u00f3m d\u01b0\u1ee3c tr\u1ecb li\u1ec7u: V\u00f2ng \u00e2m \u0111\u1ea1o c\u00f3 progestagen v\u00e0 estrogen<\/p>\n<p>M\u00e3 ATC: G02B B01<\/p>\n<p>V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel ch\u1ee9a etonogestrel v\u00e0 ethinylestradiol. Etonogestrel l\u00e0 m\u1ed9t progestagen thu\u1ed9c d\u1eabn ch\u1ea5t 19-nortestosteron v\u00e0 li\u00ean k\u1ebft \u00e1i l\u1ef1c cao v\u1edbi th\u1ee5 th\u1ec3 progesteron \u1edf c\u01a1 quan \u0111\u00edch. Ethinylestradiol l\u00e0 m\u1ed9t estrogen \u0111\u00e3 \u0111\u01b0\u1ee3c d\u00f9ng r\u1ed9ng r\u00e3i trong c\u00e1c s\u1ea3n ph\u1ea9m tr\u00e1nh thai. T\u00e1c d\u1ee5ng tr\u00e1nh thai c\u1ee7a V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel d\u1ef1a v\u00e0o c\u00e1c c\u01a1 ch\u1ebf kh\u00e1c nhau m\u00e0 c\u01a1 ch\u1ebf quan tr\u1ecdng nh\u1ea5t l\u00e0 \u1ee9c ch\u1ebf r\u1ee5ng tr\u1ee9ng.<\/p>\n<p><strong><em>C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng: <\/em><\/strong><\/p>\n<p>Ethinylestradiol gi\u1ed1ng h\u1ec7t v\u1edbi oestradiol n\u1ed9i sinh c\u1ee7a con ng\u01b0\u1eddi.\u00a0N\u00f3 thay th\u1ebf cho s\u1ef1 s\u1ee5t gi\u1ea3m s\u1ea3n xu\u1ea5t estrogen \u1edf ph\u1ee5 n\u1eef m\u00e3n kinh, v\u00e0 l\u00e0m gi\u1ea3m b\u1edbt c\u00e1c tri\u1ec7u ch\u1ee9ng m\u00e3n kinh. Levonorgestrel l\u00e0m ng\u1eebng vi\u1ec7c r\u1ee5ng tr\u1ee9ng; ng\u0103n ch\u1eb7n s\u1ef1 th\u1ee5 tinh, n\u1ebfu nh\u01b0 tr\u1ee9ng \u0111\u00e3 r\u1ee5ng; ng\u0103n c\u1ea3n qu\u00e1 tr\u00ecnh b\u00e1m v\u00e0o th\u00e0nh t\u1eed cung l\u00e0m t\u1ed5 c\u1ee7a tr\u1ee9ng \u0111\u00e3 th\u1ee5 tinh. V\u00ec v\u1eady, Levonorgestrel ng\u0103n ch\u1eb7n s\u1ef1 mang thai tr\u01b0\u1edbc khi vi\u1ec7c n\u00e0y x\u1ea3y ra. N\u1ebfu \u0111\u00e3 mang thai, thu\u1ed1c kh\u00f4ng c\u00f3 t\u00e1c d\u1ee5ng n\u1eefa.<\/p>\n<p>Etonogestrel l\u00e0 ch\u1ea5t chuy\u1ec3n h\u00f3a sinh h\u1ecdc c\u00f3 ho\u1ea1t t\u00ednh c\u1ee7a desogestrel, m\u1ed9t progestagen \u0111\u01b0\u1ee3c d\u00f9ng r\u00f4\u0323ng ra\u0303i trong thu\u00f4\u0301c tra\u0301nh thai d\u1ea1ng u\u1ed1ng. V\u1ec1 c\u00e2\u0301u tru\u0301c, thu\u1ed1c co\u0301 ngu\u00f4\u0300n g\u00f4\u0301c t\u01b0\u0300 19-nortestosteron va\u0300 co\u0301 a\u0301i l\u01b0\u0323c g\u0103\u0301n k\u00ea\u0301t ma\u0323nh v\u01a1\u0301i nh\u01b0\u0303ng thu\u0323 th\u00ea\u0309 progesteron ta\u0323i ca\u0301c c\u01a1 quan \u0111i\u0301ch. Hi\u00ea\u0323u qua\u0309 tra\u0301nh thai c\u1ee7a etonogestrel chu\u0309 y\u00ea\u0301u qua ta\u0301c du\u0323ng \u01b0\u0301c ch\u00ea\u0301 r\u1ee5ng tr\u1ee9ng. Ngoa\u0300i ta\u0301c du\u0323ng \u01b0\u0301c ch\u00ea\u0301 r\u1ee5ng tr\u1ee9ng, etonogestrel cu\u0303ng la\u0300m thay \u0111\u00f4\u0309i ch\u1ea5t nh\u1ea7y c\u00f4\u0309 t\u01b0\u0309 cung g\u00e2y ca\u0309n tr\u01a1\u0309 s\u1ef1 di chuy\u00ea\u0309n c\u1ee7a tinh tru\u0300ng.<\/p>\n<p><strong>[XEM T\u1ea0I \u0110\u00c2Y]<\/strong><\/p>\n<h3><span class=\"ez-toc-section\" id=\"52-duoc-dong-hoc\"><\/span>5.2. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p><em>ETONOGESTREL<\/em><\/p>\n<p><em>H\u1ea5p thu<\/em><\/p>\n<p>Etonogestrel \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng t\u1eeb V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel \u0111\u01b0\u1ee3c h\u1ea5p thu nhanh qua ni\u00eam m\u1ea1c \u00e2m \u0111\u1ea1o. N\u1ed3ng \u0111\u1ed9 t\u1ed1i \u0111a trong huy\u1ebft thanh c\u1ee7a etonogestrel kho\u1ea3ng 1700 pg\/ml \u0111\u1ea1t \u0111\u01b0\u1ee3c kho\u1ea3ng 1 tu\u1ea7n sau khi \u0111\u1eb7t v\u00f2ng. N\u1ed3ng \u0111\u1ed9 trong huy\u1ebft thanh c\u00f3 s\u1ef1 dao \u0111\u1ed9ng nh\u1ecf v\u00e0 gi\u1ea3m d\u1ea7n t\u1edbi kho\u1ea3ng 1400 pg\/ml sau 3 tu\u1ea7n. Sinh kh\u1ea3 d\u1ee5ng tuy\u1ec7t \u0111\u1ed1i x\u1ea5p x\u1ec9 100%, cao h\u01a1n sau khi u\u1ed1ng. N\u1ed3ng \u0111\u1ed9 etonogestrel \u1edf c\u1ed5 t\u1eed cung v\u00e0 trong t\u1eed cung \u0111\u01b0\u1ee3c \u0111o \u1edf m\u1ed9t s\u1ed1 \u00edt ph\u1ee5 n\u1eef d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel ho\u1eb7c thu\u1ed1c tr\u00e1nh thai u\u1ed1ng ch\u1ee9a 0,150 mg desogestrel v\u00e0 0,020 mg ethinylestradiol. C\u00e1c n\u1ed3ng \u0111\u1ed9 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c t\u01b0\u01a1ng t\u1ef1 nhau.<\/p>\n<p><em>Ph\u00e2n B\u1ed1<\/em><\/p>\n<p>Etonogestrel g\u1eafn v\u1edbi albumin huy\u1ebft thanh v\u00e0 v\u1edbi globulin li\u00ean k\u1ebft n\u1ed9i ti\u1ebft sinh d\u1ee5c (SHBG: sex hormone binding globulin). Th\u1ec3 t\u00edch ph\u00e2n b\u1ed1 bi\u1ec3u ki\u1ebfn c\u1ee7a etonogestrel l\u00e0 2,3 L\/kg.<\/p>\n<p><em>Chuy\u1ec3n h\u00f3a<\/em><\/p>\n<p>Etonogestrel chuy\u1ec3n h\u00f3a theo con \u0111\u01b0\u1eddng \u0111\u00e3 bi\u1ebft c\u1ee7a s\u1ef1 chuy\u1ec3n h\u00f3a steroid. \u0110\u1ed9 thanh th\u1ea3i bi\u1ec3u ki\u1ebfn kh\u1ecfi huy\u1ebft thanh kho\u1ea3ng 3,5 L\/h. Kh\u00f4ng th\u1ea5y c\u00f3 t\u01b0\u01a1ng t\u00e1c tr\u1ef1c ti\u1ebfp v\u1edbi ethinylestradiol khi d\u00f9ng \u0111\u1ed3ng th\u1eddi.<\/p>\n<p><em>Th\u1ea3i tr\u1eeb<\/em><\/p>\n<p>N\u1ed3ng \u0111\u1ed9 etonogestrel trong huy\u1ebft thanh gi\u1ea3m theo 2 pha. Pha th\u1ea3i tr\u1eeb cu\u1ed1i c\u00f9ng \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi n\u1eeda \u0111\u1eddi kho\u1ea3ng 29 gi\u1edd. Etonogestrel v\u00e0 c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a \u0111\u01b0\u1ee3c th\u1ea3i tr\u1eeb qua n\u01b0\u1edbc ti\u1ec3u v\u00e0 qua m\u1eadt theo t\u1ef7 l\u1ec7 1,7:1. N\u1eeda \u0111\u1eddi th\u1ea3i tr\u1eeb c\u1ee7a ch\u1ea5t chuy\u1ec3n h\u00f3a kho\u1ea3ng 6 ng\u00e0y.<\/p>\n<p><em>ETHINYLESTRADIOL<\/em><\/p>\n<p><em>H\u1ea5p thu<\/em><\/p>\n<p>Ethinylestradiol \u0111\u01b0\u1ee3c gi\u1ea3i ph\u00f3ng t\u1eeb V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel h\u1ea5p thu nhanh qua ni\u00eam m\u1ea1c \u00e2m \u0111\u1ea1o. N\u1ed3ng \u0111\u1ed9 t\u1ed1i \u0111a trong huy\u1ebft thanh kho\u1ea3ng 35 pg\/ml \u0111\u1ea1t \u0111\u01b0\u1ee3c sau khi \u0111\u1eb7t v\u00f2ng \u0111\u01b0\u1ee3c 3 ng\u00e0y v\u00e0 gi\u1ea3m c\u00f2n 18 pg\/ml sau 3 tu\u1ea7n. Sinh kh\u1ea3 d\u1ee5ng tuy\u1ebft \u0111\u1ed1i kho\u1ea3ng 56% t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi khi u\u1ed1ng ethinylestradiol. N\u1ed3ng \u0111\u1ed9 ethinylestradiol \u1edf c\u1ed5 t\u1eed cung v\u00e0 trong t\u1eed cung \u0111o \u0111\u01b0\u1ee3c \u1edf m\u1ed9t s\u1ed1 \u00edt ph\u1ee5 n\u1eef d\u00f9ng V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel ho\u1eb7c thu\u1ed1c tr\u00e1nh thai u\u1ed1ng ch\u1ee9a 0,150 mg desogestrel v\u00e0 0,020 mg ethinylestradiol. C\u00e1c n\u1ed3ng \u0111\u1ed9 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c t\u01b0\u01a1ng t\u1ef1 nhau.<\/p>\n<p>N\u1ed3ng \u0111\u1ed9 ethinylestradiol trong huy\u1ebft thanh \u0111o \u0111\u01b0\u1ee3c trong m\u1ed9t th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng ng\u1eabu nhi\u00ean c\u00f3 ki\u1ec3m tra d\u00f9ng 3 lo\u1ea1i: V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel (s\u1ef1 gi\u1ea3i ph\u00f3ng EE trong \u00e2m \u0111\u1ea1o h\u00e0ng ng\u00e0y 0,015 mg), mi\u1ebfng d\u00e1n qua da (norelgestromin\/EE; s\u1ef1 gi\u1ea3i ph\u00f3ng EE h\u00e0ng ng\u00e0y 0,020 mg) v\u00e0 thu\u1ed1c vi\u00ean tr\u00e1nh thai ph\u1ed1i h\u1ee3p d\u1ea1ng u\u1ed1ng (levonorgestrel\/EE; s\u1ef1 gi\u1ea3i ph\u00f3ng EE h\u00e0ng ng\u00e0y 0,030 mg) trong m\u1ed9t chu k\u1ef3 kinh \u1edf ph\u1ee5 n\u1eef kho\u1ebb m\u1ea1nh. S\u1ef1 ph\u01a1i nhi\u1ec5m to\u00e0n th\u00e2n v\u1edbi ethinylestradiol m\u1ed7i th\u00e1ng (AUC0-\u221e;) c\u1ee7a V\u00f2ng tr\u00e1nh thai Ethinylestradiol + Etonogestrel th\u1ea5p h\u01a1n c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea so v\u1edbi mi\u1ebfng d\u00e1n v\u00e0 thu\u1ed1c vi\u00ean tr\u00e1nh thai ph\u1ed1i h\u1ee3p,d\u1ea1ng u\u1ed1ng theo th\u1ee9 t\u1ef1 l\u00e0 10,9; 37,4 v\u00e0 22,5 ng.h\/ml.<\/p>\n<p><em>Ph\u00e2n B\u1ed1<\/em><\/p>\n<p>Ethinylestradiol li\u00ean k\u1ebft cao nh\u01b0ng kh\u00f4ng \u0111\u1eb7c hi\u1ec7u v\u1edbi albumin trong huy\u1ebft thanh. Th\u1ec3 t\u00edch ph\u00e2n b\u1ed1 bi\u1ec3u ki\u1ebfn \u0111\u00e3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c l\u00e0 15 L\/kg.<\/p>\n<p><em>Chuy\u1ec3n h\u00f3a<\/em><\/p>\n<p>Ethinylestradiol \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a ch\u1ee7 y\u1ebfu b\u1eb1ng c\u00e1ch hydroxyl h\u00f3a nh\u00e2n th\u01a1m, nh\u01b0ng t\u1ea1o th\u00e0nh nhi\u1ec1u ch\u1ea5t chuy\u1ec3n h\u00f3a hydroxyl h\u00f3a v\u00e0 methyl h\u00f3a. C\u00f3 c\u1ea3 c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a \u1edf d\u1ea1ng t\u1ef1 do, c\u1ea3 d\u1ea1ng li\u00ean h\u1ee3p sulfat v\u00e0 glucuronid. \u0110\u1ed9 thanh th\u1ea3i bi\u1ec3u ki\u1ebfn kho\u1ea3ng 35 L\/h.<\/p>\n<p><em>Th\u1ea3i tr\u1eeb<\/em><\/p>\n<p>N\u1ed3ng \u0111\u1ed9 ethinylestradiol trong huy\u1ebft thanh gi\u1ea3m theo 2 pha. Pha th\u1ea3i tr\u1eeb cu\u1ed1i c\u00f9ng \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi n\u1eeda \u0111\u1eddi thay \u0111\u1ed5i l\u1edbn t\u00f9y theo c\u00e1 th\u1ec3, nh\u01b0ng n\u1eeda \u0111\u1eddi trung b\u00ecnh kho\u1ea3ng 34 gi\u1edd. Ethinylestradiol kh\u00f4ng bi\u1ebfn \u0111\u1ed5i th\u00ec kh\u00f4ng th\u1ea3i tr\u1eeb; c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a c\u1ee7a ethinylestradiol th\u1ea3i tr\u1eeb qua \u0111\u01b0\u1eddng n\u01b0\u1edbc ti\u1ec3u v\u00e0 \u0111\u01b0\u1eddng m\u1eadt theo t\u1ef7 l\u1ec7 1,3:1. N\u1eeda \u0111\u1eddi th\u1ea3i tr\u1eeb c\u1ee7a c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a kho\u1ea3ng 1,5 ng\u00e0y.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"53-hieu-qua-lam-sang\"><\/span>5.3. Hi\u1ec7u qu\u1ea3 l\u00e2m s\u00e0ng:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"54-du-lieu-tien-lam-sang\"><\/span>5.4. D\u1eef li\u1ec7u ti\u1ec1n l\u00e2m s\u00e0ng:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n<p><strong><em>*L\u01b0u \u00fd:<\/em><\/strong><\/p>\n<p><strong><em>C\u00e1c th\u00f4ng tin v\u1ec1 thu\u1ed1c tr\u00ean Pharmog.com ch\u1ec9 mang t\u00ednh ch\u1ea5t tham kh\u1ea3o &#8211; Khi d\u00f9ng thu\u1ed1c c\u1ea7n tuy\u1ec7t \u0111\u1ed1i tu\u00e2n theo theo h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u00e1c s\u0129 <\/em><\/strong><\/p>\n<p><strong><em>Ch\u00fang t\u00f4i kh\u00f4ng ch\u1ecbu tr\u00e1ch nhi\u1ec7m v\u1ec1 b\u1ea5t c\u1ee9 h\u1eadu qu\u1ea3 n\u00e0o x\u1ea3y ra do t\u1ef1 \u00fd d\u00f9ng thu\u1ed1c d\u1ef1a theo c\u00e1c th\u00f4ng tin tr\u00ean Pharmog.com<\/em><\/strong><\/p>\n<p><strong><em><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/em><\/strong><\/p>\n<h2><span class=\"ez-toc-section\" id=\"6-phan-thong-tin-kem-theo-cua-thuoc\"><\/span>6. Ph\u1ea7n th\u00f4ng tin k\u00e8m theo c\u1ee7a thu\u1ed1c:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"61-danh-muc-ta-duoc\"><\/span>6.1. Danh m\u1ee5c t\u00e1 d\u01b0\u1ee3c:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>\u2026.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"62-tuong-ky\"><\/span>6.2. T\u01b0\u01a1ng k\u1ef5 :<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Kh\u00f4ng \u00e1p d\u1ee5ng.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"63-bao-quan\"><\/span>6.3. B\u1ea3o qu\u1ea3n:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Tr\u01b0\u1edbc khi ph\u00e2n ph\u1ed1i: \u0111\u1ec3 trong t\u1ee7 l\u1ea1nh (2-8oC).<\/p>\n<p>K\u1ec3 t\u1eeb ng\u00e0y ph\u00e2n ph\u1ed1i \u0111\u1ebfn 4 th\u00e1ng sau ho\u1eb7c \u0111\u1ebfn h\u1ea1n d\u00f9ng, t\u00ednh theo th\u1eddi gian n\u00e0o \u0111\u1ebfn tr\u01b0\u1edbc: kh\u00f4ng \u0111\u01b0\u1ee3c b\u1ea3o qu\u1ea3n tr\u00ean 30oC.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"64-thong-tin-khac\"><\/span>6.4. Th\u00f4ng tin kh\u00e1c :<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"65-tai-lieu-tham-khao\"><\/span>6.5 T\u00e0i li\u1ec7u tham kh\u1ea3o:<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>HDSD Thu\u1ed1c.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"7-nguoi-dang-tai-tac-gia\"><\/span>7. Ng\u01b0\u1eddi \u0111\u0103ng t\u1ea3i \/T\u00e1c gi\u1ea3:<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>B\u00e0i vi\u1ebft \u0111\u01b0\u1ee3c s\u01b0u t\u1ea7m ho\u1eb7c vi\u1ebft b\u1edfi: <a href=\"https:\/\/pharmog.com\/wp\/thong-tin-tac-gia-bac-sy-do-my-linh\/\">B\u00e1c s\u0129 nhi khoa &#8211; \u0110\u1ed7 M\u1ef9 Linh.<\/a><\/p>\n<p>Ki\u1ec3m duy\u1ec7t , hi\u1ec7u \u0111\u00ednh v\u00e0 \u0111\u0103ng t\u1ea3i: <a href=\"https:\/\/pharmog.com\/wp\/thong-tin-ve-pharmog-team\/\">PHARMOG TEAM<\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Th\u00f4ng tin chung c\u1ee7a thu\u1ed1c k\u1ebft h\u1ee3p Ethinylestradiol + Etonogestrel D\u01b0\u1edbi \u0111\u00e2y l\u00e0 n\u1ed9i dung t\u1edd h\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng g\u1ed1c c\u1ee7a Thu\u1ed1c k\u1ebft h\u1ee3p Ethinylestradiol + Etonogestrel (Th\u00f4ng tin bao g\u1ed3m li\u1ec1u d\u00f9ng, c\u00e1ch d\u00f9ng, ch\u1ec9 \u0111\u1ecbnh, ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, th\u1eadn tr\u1ecdng, d\u01b0\u1ee3c l\u00fd&#8230;) 1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c: Ho\u1ea1t ch\u1ea5t : [&hellip;]<\/p>\n","protected":false},"author":8612,"featured_media":54974,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[414],"tags":[744,2063,746],"class_list":["post-54972","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-thuoc-ket-hop-a-z","tag-ethinylestradiol","tag-ethinylestradiol-etonogestrel","tag-etonogestrel"],"_links":{"self":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/54972","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/users\/8612"}],"replies":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/comments?post=54972"}],"version-history":[{"count":2,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/54972\/revisions"}],"predecessor-version":[{"id":54978,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/54972\/revisions\/54978"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media\/54974"}],"wp:attachment":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media?parent=54972"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/categories?post=54972"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/tags?post=54972"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}