CHĂM SÓC THIẾT YẾU BÀ MẸ VÀ TRẺ SƠ SINH TRONG VÀ NGAY SAU SINH

DANH MỤC CHIA SẼ
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Bs Hồ Kim Ngân

Khoa sanh – cấp cứu

  Chăm sóc thiết yếu bà mẹ và trẻ sơ sinh trong và ngay sau đẻ là qui trình được Bộ Y tế ban hành bao gồm 6 bước, trong đó có việc da kề da ( đặt bé tiếp xúc trực tiếp trên bụng mẹ sau sanh) và kẹp dây rốn muộn là các bước cải tiến mới sau này đem lại nhiều lợi ích cho mẹ và bé sau sanh.

I. Chăm sóc thiết yếu bà mẹ và trẻ sơ sinh trong và ngay sau đẻ bao gồm 6 bước:

  1. Lau khô và ủ ấm; cho trẻ tiếp xúc trực tiếp da kề da (trẻ được đặt lên bụng mẹ ngay sau khi sinh và kéo dài ít nhất 90 phút sau sinh)

  2. Tiêm bắp 10 đơn vị oxytocin

  3. Kẹp dây rốn muộn (sau khi dây rốn đã ngừng đập hoặc 1-3 phút sau khi thai sổ) và kẹp và cắt dây rốn một thì.

  4. Kéo dây rốn có kiểm soát

  5. Xoa đáy tử cung cứ 15 phút một lần trong vòng 2 giờ đầu sau đẻ.

  6. Hỗ trợ cho trẻ bú sớm và bú mẹ hoàn toàn.

II. Lợi ích của việc Chăm sóc thiết yếu bà mẹ và trẻ sơ sinh trong và ngay sau đẻ:

  1. Da kề da:

  - Giúp gắng kết tình cảm mẹ con.

  - Trẻ sẽ không bị hạ thân nhiệt, giảm khóc và căng thẳng

  - Trẻ sẽ tìm vú mẹ sớm hơn và bú mẹ khỏe hơn.

  - Tạo điều kiện cho sự phát triển tối ưu của não bé

  - Người mẹ cũng giảm lo lắng, giảm nỗi đau “vượt cạn một mình”.

  2. Kẹp dây rốn muộn (sau khi dây rốn đã ngừng đập hoặc 1-3 phút sau khi thai sổ) và kẹp và cắt dây rốn một thì:

  - Trong 1 đến 3 phút đầu tiên sau sinh lượng máu truyền từ bánh rau sang trẻ sơ sinh khoảng 80ml và có thể lên tới 100 ml.

  - Cung cấp một lượng sắt tương ứng 40-50mg/kg cân nặng của trẻ, cùng với lượng sắt của cơ thể (khoảng 75mg/kg cân nặng) có thể giúp trẻ đủ tháng ngăn ngừa được thiếu máu thiết sắt trong năm đầu.

  - Ở trẻ non tháng: giúp giảm nguy cơ bị thiếu máu, truyền máu, giảm tỷ lệ xuất huyết não thất

  3. Hỗ trợ cho trẻ bú sớm và bú mẹ hoàn toàn

  - Cho trẻ bú mẹ hoàn toàn có thể ngăn ngừa tử vong do tiêu chảy và nhiễm khuẩn hô hấp cấp tính trong 3 tháng đầu.

  - Cho trẻ bú sớm còn làm kích thích tuyến yên tăng tiết oxytocin giúp tử cung co tốt hơn để phòng ngừa chảy máu sau đẻ.

III. Theo dõi:

  Theo dõi mẹ và bé mỗi 15 phút trong 1 – 2 giờ đầu sau sanh. Đánh giá sự ấm áp và sự thở

  - Sự ấm áp: kiểm tra nhiệt độ, hoặc sờ chân xem lạnh hay ấm nếu không có nhiệt kế.

  - Sự thở: nghe xem trẻ thở có rên không, trẻ có thở gắng sức hoặc thở nhanh không.

  Hiện tại chưa ghi nhận các tác dụng bất lợi của phương pháp “ da kề da” sau sanh. Tuy nhiên đối với trường hợp trẻ quá non tháng và trẻ không khoẻ thì không thể áp dụng phương pháp này mà phải cần can thiệp hồi sức ban đầu.

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TÀI LIỆU THAM KHẢO

BỘ Y TẾ (2016), QUYẾT ĐỊNH 4673/ QĐ-BYT VỀ PHÊ DUYỆT HƯỚNG DẪN CHUYÊ MÔN CHĂM SÓC THIẾT YẾU BÀ MẸ TRẺ SƠ SINH TRONG VÀ NGAY SAU ĐẺ

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