DnaBa 21.
HOPMANbHINONoru
HopManbHÈ noNorn- ye nonorn ogHIM
nogn y TepM0HI 37-42 TUKH0 recTauii,
AK0 NO4annoA CnOHTaHHO, 3aNMLIMNMCA
TaKMMM BIipogoBX yCIX NoNoriB, npu AKx
quTAHa HapogunaCA crioHTaHHO B ronOB
HOMY nepeAnexaHHI. TMicng nonoriB nopo
ginna iHOBOHaponKeHMH nepebyBaioTb
y3aF0BinbHOMY CTaH0.
HopMabHÍ NONorM BKAIO4aroTb MOK
nMBiCTb 3abesneyeHHA 6esnepepBHOro
KOHTaKTY "WKipa Ao uKipu" irpyaHoro
BMroNOByBaHHA BNepuy roguHY nicnA Ha
ponkeHHA AMTMHM.
BO03 Bu3Ha4ae HOPManbH0 NoNoru3a
HacTynHMMM KpMTepiaMM:
" CnoHTaHHMÀ nO4aTOK M0XK 37-M 042-M
3aBepeHMMMTUKHAMM BariTHOcT0.
" Hu3bKnùpusMK Ha no4aTKy nonoriB.
" 36epexKeHHA HM3bKOro pu3MKy ni 4ac
nonoriB.
ChOHTaHHe HapoMKEHHA AMTMHM y ro
nOBHOMY nepegnekaHH0.
lepe6yBaHHA K0HKM 0HOBOHaponke
HOro BXopouoMy CTaH0 nicnA Hapon
KeHHA.
Akyo y K0HKM Tpynu BMCOKOro pu34
Ky nonorM nepeiraoTb 6e3 yCKNaFHeHb,
BOHM TaKOK MOKyTb 6yTM B0JHeceHI A0
KaTeropii HOpMaNbHVX.
AapakTepMCTHKaHOpManbHMX N0noriB:
OAHOnNigHa BariTHICTb.
TonOBHe nepennexaHHA NNONa.
bIAnoB0AHiCTb roniBKM Nnona iTa3a
MaTepl.
AOHOIeHa BaritHICTb 37+1 TUKH0B
41*0 TUKH0B (B0J nepworo AHA OcTaH
HboÏ MeHCTpyaui).
KoopaMHOBaHa pogOBa AiAnbH0CTb,
AKaHe noTpebye Kopuryio4oi Teparnii.
" HopManbHMG MexaHi3M nonoriB
(nepegHiMaÑo 3aAH0MBUA noTMNVYHO
ronepennexaHHA).
" CBOE4aCHe BMNMTTA HaBKONonnigHMX
BOA npu po3kpuTT0 WMÄKM MaTKM 6inb
we 5 CM BaKTVBHY þasy nepworo ne
piony nonoriB.
" BingineHHA nayeHTM i HaponkeHHA
nocniny B0FóyBaeTbCA caMOCTÍMHo
a6o npu akTMBH0GTaKTMLÍ BegeHHA II
nepiony nonori.
" BincyTHICTb p03pMBiB TKaHMH Pogo
BOro KaHany aóo TiNbKM He3Ha4H0, NO
BepXHeB0 yUKOAKeHHA.
BincyTHÍcTb onepaTMBHMX BTpy4aHb
nig 4ac noNoriB.
" isionori4Ha KpOBOBTpaTa B cepen
HbOMY CTaHOBMTb He 6inbwe 0,5 % B0a
Macu Tina (perenbHMmO6niK).
CepegHA TpMBanicTb þi3ionoriyHMX no
NoriB y cy4aCHMX YMOBax KoMBaeTbCA
Big 7-8 go16 rogy nepBicTOK (He 6iNb
we 18 rOA), 0B0g 5-6 10 10 ron y n0
BTOPHOponAMx (He 6inbwe 12 roa).
HapopxeHHA KVBOÏ 0340pOBOÏ AOHO
weHOI AMTMHM.
Ou0HKa 3a WKanOo Anrap Ha 1-H i5-4
XBMNMH0 KMTTA AMTMHM BIAnoB0Fae
86anaM06iNbwe.
327
iaBa 21. HopManbH0 NoNorn
 OCHOBHa MeTa HagaHHA gonOMorM ig
Yac HopMaNbHMX Nonor0B - 3a6esne4MTM
6esneky gAK0HKU 0gMTMHM N0g yac no
noriB Ipu M0HI0MaNbHO MOXIMBOMy BTPy
yaHH0 y isionoriyHMHnpoyec.
06'eKTHBHÈ 03HaKM novaTKy nonoriB:
CTpyKTypHi3M0HM IMKN MaTKV;
CKOpO4eHHA MaTKM 3 neBHOHO pery
NApHiCTHO (nig 4ac aKTMBHOÏ a3M He
MeHWe 3-x 3a 10XB):
lepiogu nonoris (Ta6n. 21.1)
lepwn nepiog nonori.:
3M0Ha opMM Ta po3TauyBaHHA WMM
KM MaTKM- nporpecMBHe BKOPO4eH
HATa 3rnankyBaHHA,
po3kpuTTA WMMKM MaTKM - 36iNbuweH
HA AiaMeTpa kaHany unÝKMMaTKM (BM
MipioeTbCA BCaHTMMeTpax);
nocTynoBe onyckaHHA roniBKM nnoga
y nopoKHVHY Manoro Ta3a B0FHOCHO
nnoMHV BXOAyy Manu Tas (3a naH
MM 30BH0UHbOroakyuepcbKOro A0cni
AKeHHA) abo BiqHOCHO lin. interspinalis
(npn BHyTpiwHbOMy AocniFxeHH0).
lepun nepiog nonoriB 3aBepuyeTb
CA NOBHMM po3KpuTTAM WnMKM MaTKM.
TpuBanicTb nepioro nepioAY y nep
WoponaMX B0 5-6 A0 14 roA, y
HOpogAnx - B0A 4-5 A0 9 rog. noBTOp-
basu nepuoro nepioAy:
lateHTHa pasa - se npOMIKOK 4acy
BiA no4aTKy peryNApHOI poA0BOÏ AiAnb:
HOCT0 A0 nOBHOro 3rnanKyBaHHA WMMKM
MaTKM ipo3KpuTTA A03 CM (y nepBicTOK
i go 4 CMynoBTOpHopogAMx.
BnaTeHTHY þa3y nonoriB He pekomeH
AyeTbCA npoBeneHHA aMH0oTOM, BMKOpy
CTaHHA yTepoTOH0K0B.
AKTHBHa pasa - po3kpuTTA WnKM
MaTKM B0. 3-4 CM A0 10 CM. lBugkicTb
po3kpMTTA WMMKn MaTKM 1,5-2 CM/ron
y nepBicTOK 02-2,5 CM/roA y noBTopHO
pogAnX. MiH0ManbHOIO HopManbHOO
WBVAKiCTHO po3KpMTTA WMVKM MaTKM
BaKTMBHy asy BBaKaeTbCA 1CM/rog (AK
ynepuuX, Tak 0BNOBTOpHMX noNorax).
BakTHBH0m hasi BuinAoTb TPM ningasu:
liggasa npucKopeHHA npn nepunx
nonoraX TpVBae n0 2 rOg, ipu nOBTOp
HVX - Ao 1rog.
liggaga MakcUMaNbHoro nigHomy
TpVBae aHanoriyHVMnepiog 4acy.

Ta6nnsg 21.1.MiarHOCTHKa nepiogis i gas3 nonoriB

XapakTepncTMKa lepiog a3a
WnäKa He po3kpTa XnóHi nonorn(BiFcyTHÍCTb
nonoroBoi gianbHOCTi)
Wnäka MaTKM po3KpuTa MeHWe H0X Ha 3 CM SlateHTHa

uwkaMaTKM po3kpuTa Ha 4-8 CM. Ilo4aTOK npocyBaHHA roniBKM AKTMBHa

nnoga
loBHe p03KpuTTA WnKM MaTKM (10 CM) PaHHA
ToniBKa nnogaBnopoxHMH0 Manoro Ta3a. Ilo3MBM A0 nOTyr B0ncyTH0
loBHe po3KpMTTA WnKM MaTKu (10 CM). AKTMBHa(noTyrM)
Mepegnerna yacTMHa nnoAa A0cArna Ta3OBOro AHa. lo4aTOK noTVr
TpeT0M nepiog noMHaeTbCA 3 MOMeHTY HaponKeHHA AMTMHM 0 3aK0H
yeTbCA BMAineHHAM NOcniAy

328 naBa 21. HopManbH0 nonorn

 indasa ynoBiNbHeHHA TPMBae Big 8
CM 10 nOBHOrO po3kpMTTA WMMKM MaTKM
ynepBicTOK Bin 1 40 2 ron, y nOBTOPHO-
pogauMx-A0 1rOg.
3rnanxyBaHHAipo3KpMTTA UMMKM MaT
KM ynepUO- InOBTODHOponAMX B0FóyBa
eTbCA nOpi3HOMY: y nepBicTOK Cno4aKY
BinóyBaeTbCA 3rnaAKYBaHHA, a noT0M po3
KDMTTA WMMKM MaTKM, y noBTOpHOponAMX
uinpouecM BIAóyBaoTbCA OAHOYaCHO.
OuiHKa nporpecyBaHHA NONoris
3 MeTOKO O;IHKM nporpecyBaHHA ono
riB BM3Ha4aoTb:
WBMAKicTb po3KpuTTA WMMKM MaTKM -
BM3Ha4aeTbCA BHYTp0UHbOMY
akywepCbKOMY A0CHiNKeHH0, AKe Bak
TMBHY asy ipoBOnMTbCA KOKH0 4 rog;
4acTÍWe A0cNiAKeHHA npoBOAMTbCA
3a noka3aHHAMU (nepegaCHMÝ CIOH
TaHHMMp03pVB nniFHoro M0Xypa, 3M0Ha
cepyeTTA NNoAa - MeHWe 110yA/
XB aóo 6inbwe 170 ya./xB, BANagiHHA
nynoBMHM; nigospa Ha HeipaBnbHe
BCTaBNAHHA/nepepnexaHHA roniBKM,
KpOBOTeya - ornAA BOnepauiDHiM);
4acTOTy Ta TpMBanicTb nepeM (Hop
Ma BakTMBHY asy 3-4 nepeMM 3a
10XB 3 TpMBanicTHO 6iNbwe 40-50c);
MA BI3Ha4eHHA B0AHOWeHHA rONIBKM
nnog AoinoMH BXOAY B ManMÝTa3
3a qonoMOrOHO 30BH0LWHbOrO akyuep
5/5 4/5 3/5
o hNepegHa yepeBHa cTÍHKa
NnouMHa BXOAy
A0 Manoro Ta3a
Phc. 21.1. OuiHKa BiAHOWeHHA roniBKM NNOga Ao nnoWHM BXOAYy BMannA Tas
CbKOro A0cninkeHHA BIKOpMcTOByeTb
CA MeTOA lanbnasïroniBKM nnOga Han
CMMþi3OM 0LUMpMHa nanbiB akyuepa,
KiNbK0CTb AKMX BignoBinae CTYneHKO
BCTaBeHHA roN0BKM Noga B ManMM
Tas (no3HayaeTbCA AK 0) (puc. 21.1):
5/5 - roniBKa nnoga 3HaxonMTbCA
Han BXOFOM y ManuA Tas, 4/5 - ro
IBKa npuTMCHYTa no BXOgy BMann
Tas, 3/5 - roniBKa ManMM cerMeHTOM
y BXONi BManMM Ta3, 2/5 - roniBKa
BeNMKMM CerMeHTOM y BXOAI B ManM
Tas, 1/5 - roniBKa 3HaxonTbCA B no
poKHMH0Tasa, 0/5 - HaTasOBOMy AHi.
AMHaMIky npocyBaHHA roniBKV No
Aa y nopoKHVHY Ta3a 3a BM3Ha4eH
HAM NONOKeHHA roniBKV NNoga oA0
lin. interspinalis (BHYTpiJHe akyuep
CbKe A0cniFxeHHa) (AMB. pMC. 21.2).
CrnocTepexeHHA 3a poginnero BKIIO
yae:
BVCIyxoBYBaHHA cepyebUTTA NNoga
(HopMa 110-160ya./xB):
y nepWOMY nepioni nonoriB - KOKH0
15-30 xB npOTArOM OQHiei noBHOI
XBANMHM nicnA 3akiH4eHHA nepe
MMV;
y ApyroMynepioni- KOKHi 5 XB abo
iicnA KOKHOÏ NOTyru;
pyTMHHe 3acTOcyBaHHA KTT BCiM
nopoginNAM He BunpaBnaHe, oco6
2/5 1/5 0/5
lopoxHMHa Ta3a
TnaBa 21. HopManbHi nonorM 329
 5 CM
4 CM
-3 CM
-2 CM
1CM
Sp ++1CM Sp
+2CM

4CM

Puc. 21.2. Bu3HayeHHA posTauyBaHHa roniBKMnNoga BiHoCHO lin.

HbOMy AocniqxeHH0: interspinalis npu BHyTpiu
-3 - roniBKa Hag BXOFOMy ManuM Ta3,
-2-roniBKa npMTMCHYTa g0 BXOAy BManmw Ta3,
-1-roniBKa ManMM CerMeHTOM y nnoMHÍ BXOAy B ManuM Ta3;
0-ro0BKa BeNMKMM CerMeHTOM y nnouMHÍ BXOAy BManM Ta3;
+1 - roniBKa BenMKMM CerMeHTOM y wnpoKiM 4acTMHÍ ManorO Ta3a;
+2 -roniBKa y By3bKiM 4acTMH0 Manoro Ta3a,
+3-roniBKa Ha TaOBOMy AH;
+4- roniBKa Bpi3yeTbCA i npopisyeTbCA

NMBO B rpyni nonoriB HM3bKOro pu rinoTOHÍIO, aHOManií cepyeBoro puTMy

3MKy, oCKiNbKM BICOKMG BiFcoTOK
XM6HONo3MTMBHMX pesynbTaTiB
36inbuye yacTOTy BTPy4aHb, BTOMy
4ncnionepaTMBHMX NONOriB.
BIM0DIOBaHHA nynbcy, AT - KOKH0
2 ron (3a BMHATKOM rinepTeH3MBHMX
po3naFiB);
BMMipIOBaHHA TeMnepaTypu Tina -
KOKH04 rog;
4acTOTamobcAr ce4OBMnyCKaHHA - ca
MOKOHTPonb >K0HKU (Heo6xiAHO npono
HyBaTu 4acT0We B0AB0AyBaTU TyaneT).
lCHye Mano goka30B TOro, Io bygb-AKa
no3MiA e OnTIMaNbHOHO B oNorax.
PekOMeHAyeTbCA yHVKaHHA NONOKeH
HA Ha cnMH0, OCK0NbKM Ue noB'A3aHO 3 He
cnpuaTNMBIMU HacniFkaMM, BKIIO4aio4n
baxaHo cipuaTU Ta niATpMMYBaTM
npuHATTA BepTMKaNbHMX (Ha KoniHax,
npucinaHHA aóo CTOAYM) ÍMO6iNbHVX
no3MuiH. lopiBHAHO 3 opn3OHTanbHM
MM BepTIKaNbHÍ nonOKeHHA Bnonorax
nOB'A3aHÍ 3Í 3MeHweHHAM TpMBanocTÍ
nepworo eTany. lonoroBn M'AY MOxe
QyTM eekTMBHMM 0HCTpYMeHTOM ANA
3HMKeHHA ÍHTeHCMBHOCTÍ 6oNHo úonTUM0I
3auií nonOKeHHA noge puc. 21.3).
TlonoKeHHA Ha KoniHax i nonOKeHHA
Ha KoniHax 3 ynopoM Ha pyku noB'A3aHi 31
36iNbweHHAM acTOTM ÍHTaKTHOi ipoMe
KVHM. Cugg4Í nonoKeHHAÍpogoBÍ CTINb;
noB'A3aH0 3i 36inbweHHAM YaCTOTM TpaBM
npOMeKVHM.

330 Dnasa 21. HopManbH0 NOnorn

 XonA4M, CTOR4M, CMpako4ucb

CTOAYM HaBKONILUKM

CuaAYM HaBnO4iNKM

Puc. 21.3. BinbH0 nonoxeHHA poginni Bnonorax

TnaBa 21. HopManbH0 noNOru 331

 BepTMKanbHe nonoKeHHA Ha ApyroMy
eTani nOB'A3aHe3 (3aranbHa AK0CTb 10Ka
30B HM3bKa):
3HaYHM CKOPO4eHHAM 4MCNa BTpy
4aHb nin 4ac nonoriB;
" 3HVKeHHAM 4aCTOTM enisioTOMiI:
nigBMIeHHAM 4acTOTM pospuB0B ipo
MeKMHn Apyroro CTYneHA,
nigBMeHHAM 4acTOTM KpOBOBTpaTM
6inbwe 500 MI;
" 3MeHWeHHAM TpMBanOCT0 APyroro eTa
ny nA K0HOK, AK0BKe HaponkyBanM.
Apyru nepio nonoris (nepiog BH
THaHHA) - B0g noBHOrO p03KpMTTA UMMKn
MaTKM A0 HaponKeHHA AuTUHM.
noTyrM - puTM0IYHe noenHaHHA CKOpo
yeHHA MaTKOBO0 MyCKynaTypu, YepeB
HOro npecy, giaparMu iTa3OBOro AHa;
Bpi3yBaHHA rON0BKM - roniBKa nnoga
3'ABNAETbCA y ByNbBapHOMY Kinb4i
TiNbKM Nig4ac noTYrM,
npopisyBaHHA rOniBKM roniBKa 3Ha
XOFMTbCA y BynbBapHOMy Kinbyi nicna
npunMHeHHA NOTYrM.
PospisHAIOTb AB0pasu Apyroro nepio
Ay nonoriB - paHHKO (nacMBHY) Ta akTUB
Hy:
" paHHA pasa Apyroro nepiony- Big
nOBHOro po3kpuTTA WnMKM MaTKV A0
noyaTKy noTyr,
aKTMBHa pasa Apyroro nepioAy - a3a
noTYr.
TpuBaniCTb |l nepiony nonoriB y nep
BiCTOK He nOBMHHa CTaHOBMTU 6iNbWe 2
roA, y noBTOPHOpOgA- 6inbue 1 rog.
TpetiH nepiog nonoris no4MHaeTbCA
nicnA HaponxeHHA AMTMHM 03aBepuIyeTb
CA HapoAKeHHAM NnayeHTM 0060nOHOK.
¬ AB0 TakTMKM BeneHHA TpeTbOro ne
piogy nonori.:
O4iKyBanbHa,
" aKTMBHa.
AKTMBHa TakTMKa BegeHHA II nepiogy
Mae 6yTM 3anponOHOBaHa KOXHÍM Naui
EHT;0 3 HanaHHAM nOBHOÏ yCHoï Ta nMCb
332 naBa 21. HopManbH0 NONOrn
MOBOÍ 0HopMaLyii npo noTeHL0MH0 nepe
Baru iHegonikn akTMBHOI M
O4ikyBanbHoi
TaKTUK BeneHHA 3-ro nepiogy.
KOMNOHeHTMaKTMBHOrO BeneHHA Tpe
TbOro nepiogy nonoriB:
BBeAeHHA yTepoTOH0K0B;
HaponkeHHA NOCIIAy unAXOM KOHTDO
NbOBaHoi TpakLii 3a nynoBMHY 3 OgHO
4aCHOO KOHTPTPaksjeo Ha MaTKy;
" Macax MaTKM Yepe3 nepeAHIO 4epeB
Hy cT0HKy nicnA HaponkeHHA Nocnigy.
BiFcyTHIcTb ONHOro 3 nepepaxoBaHx
KOMNOHeHT0B BVKIIO4ae akTUBHe BeneH
HA |Il nepiogy nonorie!
OyiKyBanbHa TaKTMKa BegeHHA |Il ne
piony nonoriB
Nicna 3akiHYeHHA nynbcail npOBO
AMTbCA KNeMYBaHHA Ta nepepi3aHHA
nynoBMHM.
ipoBOAATb peTenbHe cn0cTepexeHHA
3a 3aranbHMM CTaHOM nopoginni, KiNbK0
CTHO KpOB0, LÊO BUAnAeTbCA, M03HaKaMM
B0AgneHHA NNayeHTM.
O3HaKM B0AgineHHA nnayetH
O3Haka Wpenepa - 3M0Ha oopMu Ta
BMCOTM CTOAHHA AHa MaTKM. IlicnA B0Awa
pyBaHHA NnaLeHTM MaTKa BUTAryeTbCA
no goBXMH0, AHO nigiýMaeTbCA BMLJe Big
nynka iB0FXVNAETbCA BIpaBO B0A Cepen
HbOÏ N0H.
O3Haka ANboenbAa - niratypa, Hakna
AeHa Ha nynoBMHy 6ina cTaTeBOÏ uinMHM,
npu BiFuapyBaHH0 nnayeHTM onyckaeTb
CA Ha 10-12 CM.
O3Haka YykanoBa - KiocTHepa- npM
HaTMCKaHH0 peópoM pyKu Hag noóKo
BIM CUMOi3OM nynOBMHa He BTAryeTbCA,
AKLIO nayeHTa B0AAMnacb.
O3Haka AOBxeHKa - nig yac rnMóOKO
ro BAMXy Ta BMAVMxy nynoBIHa He BTArY
eTbCA IHe onycKaeTbCA.
Tipu noAB0 03HaK B0AgneHHA NNayet
TU K0Hs0 nponoHYIOTb HaTy>KVTMCb, o
npu3BONuTb A0 HapogxeHHA nOCniAy
(puc. 21.4).
 A

Pc. 21.4. TunMBinAineHHA nNayeHTW:

yeHIpanbHe B0FgineHHA nnaueHTM 3a lynbTye. 5 - B0AAineHHA nnaueTM 3 Kpao, 3a AyHKaHOM

PesynbTaTM cnocTepexeHHA 3a
da BiFcyTHOCTÈ 03HaK B0AgineHHA Nna
nporpecOM nonoriB, CTaHOM MaTepi
LueHTM npoTAroM 30 XB nicnA HaponkeHHA Ta nnga 3aHOCATbOA A0 napTorpaMU
nnona
LeHTM TanpoBOnATb
pyHe B0AFineHHA NNa-
BMgineHHA NOCH0Ay; ypasi BMHMK- (AMB. puc. 21.5).
HeHHA KpOBOTeyi pyYHe B0FgineHHA Nna- Ilaprorpama - rpaiHe BigoópaxeH
HA pe3ynbTaT0B AMHaM0HHOrO cnocTe
LLeHTM Ta BMganeHHA NOCNiAy npoBONATb
pexeHHA Nig 4ac nonoriB 3a npouecOM
HeramHO nig agekBaTHMM 3He6oneHHAM.
naBa 21. HopManbH0 NONOru 333
 laprorpama
nplaBmuye BariTHIcTb
PeectpauiÛHM HOMep
Aara HanxogxeHHA Yac HanxoAkeHHA yac BinxoAkeHHA BoA
180
170
160
CepyeóurTA 150
140
nnoga 130
120
110
100
HaBKononnigHiBOAu
KOHirypauia
10
AKTMBHa asa
n0H0
N A
MNbHOCT0

7
Po3KpuTTA 6
WMMKM MaTKM 5
4
NpoxonkeHHA 3 NateHTHa casa
roniBKM nNOga 2
1
0

Yac a
MaTKOBi CKO
po4eHHA KOKH0
10XB.
OKCMTOLMH B/B
BBegeHHA

OTpMMaHÍniKM
180
170
160
lynbc 150
140
130
120
110
AT 100
90
80
70
60

TemnepaTypa
lporeiH
Ceya AeTOH
06eM

Puc. 21.5. Ilaprorpama

334 naBa 21. HopManbHi nonoru

po3kpuTTA uMKU MaTKM Ta npocyBaHHA
roniBKM nonoroBOO AIANbHICTHO,
cTaHOM MaTepi Ta nnoga.
BrnpoBanKeHHA Ta npaBUNbHe BUKO-
pucTaHHAg napTorpaMM 3Ha4HO nokpaiye
AK0CTb CcinoCTepeKeHHA 3a poginnero Ta
HacnigKM nonoriB.
BMKopMCTaHHA NaprorpaMM A03BONAE:
. paHO BVABMTM He3aFBINbHMö nDo
rpec nooriB;
. nonepennTM po3BNTOK TpVBanux no
noriB,
. ByaCHO BM3HaYMTM KIÍH04HO By3bKMM
Ta3,
CBOE4aCHO npuMHATM O6rpyHTOBaHe
piweHHA Ioooglboi TaKTMKV Be
geHHA onoriB;
" BM3Ha4MTM 06CAr Heo6XiFHVX BTpY
4aHb.
CKnanoBi yacTHHM naprorpamH:
|- cTaH ninogiacTOTacepueBnx CKO
po4eHb, CTaH nnigHOro M0Xypa Ta HaBKO
nonniFHMx BOA, KOH)irypauia roniBKM.
||- nepe6ir nonoris: TeMn po3KpuTTA
WnMKM MaTKM, onyCKaHHA roniBKM NNoga,
CKOpO4eHHAMaTKM.
IIl- craH x0HKM: nynbC, aprepianbHMÄ
TMCK, TeMneparypa, ce4a (6'eM, 6inoK,
ayeTOH), pexMM BBeneHHA OKCMTO;MHY Ta
lIKM, o BBONATbCA nìg 4ac nonoriB.
lacnopTHa 4aCTMHa M0CTMTb HaCTY+Hy
IHQopMaLuiko: npisBMe, im'A Ta no 6aTb
KOBI poginni, nopaAKOBMÝ HOMep Barit
HOCT0, K0NbK0CTb nonoriB B aHaMHe3I, AaTy
T9ac HagxonKeHHAA0 nonoroBoi nanaTM,
TpMBanicTb 6e3BoNHOro npOM0KKY Ha MO
MeHT HaFxopKeHHA A0nonorOBOÏ nanaTn
(AKLIO nniqHM M0xyp yinmñ, CTaBITbCA
npoyepk), Nº icTOpii nonoriB.
Ukana "Yac Bino6paxae peanbHMn
Yac (rogMH/XBMJMH) 3 MOMeHTY HaFxo
HKeHHA no nonoroBoi nanaTM Ta Bnpo
HOBX nonoriB. KoxHa 3 24 KIITVH NpeA
CTaBNAe npoM0KOK(4acy B1 rog. 3Ha4eHHA
4acy Bino6paxaeTbCA 3N0Ba BiF BepTMKa
ni, AK0M LÊe
3HaYeHHA B0AnoBInae.
BinnoBiHO A0 uiei UKann sai~CHKO
OTbCA BC0 3anMCM Ha napTorpaM0 y rpa
9ax, o posTauOBaH0 BMuje Ta HMK4e
WKanu"Yac".
|- CTaH iNoga
YacTOTa cepyeBMX CKOp04eHb.
BepTMKanbHa BiCb rpau Biqo6paxae
4acToTy cepueBux CKOpO4eHb nnoge 3a
XBMNMHY. TeMHIIi ropnsOHTaNbH0N0H0, Luo
B0FnOB0NakoTb 110 Ta 170 ya/xB, Harany
OTb np0 MeK0 HOpManbHOi 4CC nnoga.
KoXHa KN0TMHa no ropu3OHTani npen
CTaBNAE npoM0KOK 4acy B15 XB. MinAHKM
rpaou HMKYe 100yA/xB Ta BMLÊe 180yA./
XB E 03HakaMM AMCTDecy nioga.
NigpaxyBaHHA 4acTOTM cepyeBMX
CKOpO4eHb nnoga wnAxOM nepiogvHOI
ayckynbTauii 3giñCHIOETbCA 3a AonOMO
rOo akyuepCbKoro cTeTOCKOna a6o py4
HOro nonnepiBCbKoro aHanisaTopa cepye
BOÏ AiANbHOCT0NNona.
YacToTy cepeBnx CKOpo4eHb NNoga
nigpaxoBYIOTb i 3aHOCATb Ao napTorpaMn
KOKH015 XB.
No4MHaTM ayckynbTaLio chin oApa3y
nicna 3akiHYeHHA oasu Hamóinbw iHTeH
CMBHOrO CKOpo4eHHA MATKMNig Yac nepe
}MM Ta 3FiHCHIOBaTV npoTArOM He MeHWe
H0K 60c, K0HKa npu ubOMy neKMTb Ha
6oui.
BiFoópaKaeTbCA y BMrNAAi no3HayKM
(), AKa HaHOCMTbCA Ha nepexpecTA M0K
ropu3OHTanNIO, uo BiAnoB0Fae 3HayeHHIO
4CC nnona, Ta BepTMKannKO, Io BiFnoBi
gae peanbHOMY 4acy Ha MOMeHT peecTpa
yiï YCC. Bci no3Ha4Kn 3egHyIOTbCA NiHig
MM, yTBOpoBo4M rpaik.
HaBKoNonnigHi BOAu
KoKHa KN0TMHa rpaou BIAnoBIgae npo
MIKKY 4acy B 30 XB.
CraH nniAHoro Mixypa ouiHOeTbCA i
3anmcyeTbCA NiA 4ac KoKHOrO BHYTpi
HbOro akyuepcbKOro AocninkeHHA.
naBa 21. HopManbH0 NONOrM 335
 CraH HaBKONonnigHMX BOA ou0HIOIOTb
Ta sanMcyIOTb npu pospuB0 nnoAOBMX
o6onOHOK, a qani nig yac KOXHOro BHYT
piuHboro akyuepCbKOro A0cnieHHA.
iTepa Mae QyTM BnMcaHa y kniTMHy, o
posTauOBaHa npaBopy4 B0A BepTMKani,
AKa B0FnoBiFae neBHOMY 3HaYeHHIO pe
anbHOrO 4acy wKan "Yac",
3anuc:
nniqHnùM0Xyp yinm - L;
HaBKONOnnigHi BOAM nposopi -;
MeKOH0anbHe 3a6apBneHHA BON - M;
BOAM 3a6apBneHi KpOB'o - K.
KOHpirypauia roniBKM NNOga.
KoXHa KN0TMHarpau BiFnoBiFae npo
MIKKY 4acy B30 XB.
CTyniHb KOHOirypauiï roniBKM nnOna
O;IHIOKOTb Ta 3anncyioTb nig 4acKOKHOrO
BHYTpiWHbOro aKywepcbKoro nocninKeH
HA. loHaYKa Mae QyTM BIMCaHa y KniTM
Hy, uo po3TaIOBaHa ipaBopyy BIA BepTM
Kani, AKa B0FnOB0gae neBHOMY 3HayeHHIO
peanbHoro 4acy uUKaNn "Yac".
3anuc:
" WBM Ha roniIBL0 NNOga nerKO BM3Ha4a
OTbCA, KOHirypauig roniBKM NNoga
BiFcyTHA-"0
" K0CTKM Ha rONIBL.I NOga cTMKaioTbCA
OgHa 3 OHOO, WBM He BV3HaaoTbCA
(KOHþirypauia IcT) - +;
KiCTKM Ha ron0B;0 NNOna HaxONATb
OAHa Ha Apyry (KOHþirypauia Il cr) -
"++" a6o "2+":
" KÍCTKA Ha ON0BLI0 nNoge 3HaYHO Ha
XOnATb ONHa Ha Apyry (KOHirypayia
IllcT) -"+++" a6o "3+".
NB! KOHoirypayig roniBKu Il cryneHA y no
egHaHH0 3+pnsynMHeHHAM po3KpuTA wniKn
MaTKU Ta/a6o B0FcyTHÍCTIO OnyCKaHHA roniBKU
nnoga Ha hoHi aKTUBHOÏ N0NorOBOÏ giANbHOCT0
e 03HakOHO KJ0H0YHO BY3bKoro Ta3a.
I| - nepe6ir nonoriB
Po3KpuTTAWW0KM MaTKM
336 naBa 21. HopManbH0 nonorM
BeprMKanbHa B0Cb rpau BiFo6paxae
posKpuTTA WMMKV MaTKM BCaHTUMeTDay
BiF 0 go 10.
Topu3OHTaNbHa BiCb - IKana 4acy.
Tpaa
posnonineHa Ha naTeHTHY Ta
akTMBHY þasu nonoriB.
NateHTHa hasa - nepion, KoM p03
KpUTTA WMMKM MaTKV CTaHOBMTb MeHu
H0K 3CM. TeMHIwa
ropv30HTanbHa iHia,
LÊo B0AnOBigae 3 CM po3KpuTTA uM`KM
MaTKM, Ta BepTMKalbHa, o BIAnOB0Nae
8-H rogMH0WKaIM 4acy,
BIAOKpeMNHOYOTb
naTeHTHy þasy nepioro nepioay nono
riB B0A akTUBHO1. BHOPMI TpMBaniCTb Na
TeHTHO0 asu He noBMHHa nepeBMIyBaT
8 rog.
AKTMBHa oasa ye nepIOA po3kpuT
TA WMKM MaTKM B0A 3 A0 9
caHTUMeTpiB.
TpuBanicTb aKTMBHOÏ aM 3aneKUTb BiA
TeMny p03KpMTTA WMMKU MaTKM. YacTMHa
rpau, uIO B0AnOB0gae akTMBH0M þasi, Mae
AB0 TeMHIWÍ NOXVN0N0HIl- n0H0O yBarn Ta
niH0O A.
TliHia yBaru no4MHaeTbCA y TOYLi, uo
BIFnOBInae po3kpuTTO 3 CM, I npoAOBKY
¬TbCA A0 no3HaYKM OBHOrO po3kpTTA
UMÝKM MaTKM. JliHiA yBarn B0FnOB0Fae
TeMIy po3KpuTTA uM}KM MaTKM 1 CM/
rog. WBnAKicTb po3KpMTTA IHÄKM MaTKH
1CM/ro BaKTHBHY Qasy nepworo nepio
AV nonoriB e M0H0MaNbHOIO HOpMaNbHOO
AK ANA K0HOK, LÊoHapogKyoTb BNepue,
Tak igNA K0HOK, u;o HapogxyioTb n0
BTOPHO.
liais Aiï npoxoFTb napanenbHO N0H0I
yBaru, BInCTynMBUM B0A Hei Ha 4 rog npa
BOpy4. 3HayeHHA po3kpuTTA uMKM MaT
KV BV3Ha4aeTbCA nig4ac KOKHOrO BHYT
piwHbOro akyuepcbKOro A0cniqxeHHA.
PesynbTaTM ou0HKM po3KpuTTA WMMKM
MaTKM B0g3Ha4aoTb Ha napTorpaMi no
3Ha4KOHO (X), o Mae 6yTM po3TawoBa
Ha Ha nepexpecT0 M0K rOpu3OHTanN i0,
AKa BignoB0Fae 3HaYeHHO po3kpMTTA
wnÕKM MaTKM, Ta BepTMKannio, AKa BIA
noB0gae 4acy o6CTeKeHHA. lo3HayKM
3egHyioTb 6e3nepepBHOHO n0HieO
KONM BMKOHy¬TbCA ne-
(Kp0MBMNagky,
peHoc) CTBOPIOKO4M rpaik po3kpuTTA
UMÖKMMaTKM.
0co6nMBOcT0 HaHeceHHA po3KpuTTA
WHÖKM
|MaTKM. A AKIO KIHKa HaXoATb A0
nonoroBoi nanaTM y naTeHTHIM basi nep-
IOr0nepioAy nonorIB, po3KpuTTA LMKM
MaTKM (X) HaHOCATb Ha BepTMKaNbHy BiCb
roadu yMICUI, OBIFnOBIAae 3Ha4eHHIO
po3KpuTTA,
yepes 4 ron ipoBOAATb HacTyIHe
BHYTp0UHe akyiepCbKe gocNipkeHHA Ta
OTDMMaH0 pe3ynbTaTM 3aHoCATb F0 nap
TOrpaMM. Ilo3Ha4KM (X) 3eAHyioTb 6e3ne
pepBHOHO niHieo.
MoKnMB0 HacTyNH0 BapiaHTM:
BapiaHT 1: po3kpMTTA WnMKM MaTKM
nig vac Apyroro BHyTpiWHbOro akywep
CbKOro A0cniFkeHHA MeHW H0K 3 CM. X
6yae postauioBaHe HMKYe TeMHOÏ ropM
30HTaNbHOi niH, o npoxoguTb Ha piBHi 3
CM po3KpMTTA WMKM MaTKM.
BapiaHT 2: poskpMTTA WMKM MaTKM
3CM i6inbwe. X 6yAe postauuOBaHe 6es
nocepegHbO Ha TeMHÌM ropM3OHTaNbH0M
IHI, Io npoxogMTb Ha piBH0 3CM po3
KpMTTA WMÌKM MaTKM (AKLIO poskpuTTA
AOpiBHIOE 3 CM) a6o BMe (y pasi HaABHO
CTI posKpMTTA6iNbw H0K 3 CM). lo3Ha4
KM (0) s'enHyioTb 6esnepepBHOKO NiHieO.
baplaHT 2 CBIN4MTb npo Te, lo nonorM
iepemunu BaKTMBHy hasy nepuoro ne
pioAy. Akuyo nonorn nepeHuNH BaKTHBHY
pa3y nepuoro nepiogy,XMae 6yTH nepe
HeceHe 6esnocepegHbO Ha Slin0o yBar.
AnA ubOro 3HaxonATb M0CIe, y AKOMY ne-
pexpeiyOTbCA ropu3OHTaNbHa niHig, Êo
BiMaTKM,
AnoB0naeTa liHiA
3HaeHHHO po3kpuTTA WMMKM
yBarn. Ha ye MiC;e chiA
nocTaBMTM X. 3'egHyroTbCA o6uNBa X, yo
3HaxonATbCA
nonioHOo
Ha OAHIM ropn3OHTani, Ayro-
nepepB4aCTOO n0H0eHO, AKa
CMMBONi3ye nepeHOC.
Yac, y AKuH 6yno npoBegeHo BHYTp0LI
He akyuepcbKe A0cniqxeHHA, CA0A Ta
KOK nepeHecTH ipo3TauyBaTn 3niBa Bi
BepTHKani, Ha AKiH 3HaxoquTbCA nepeHe
ceHMÝ Ha liH0o yBaru X.
BinHoCHO 4acy, AKMG nepeHeceHO, BA
KOHYIOTb nepeHeceHHA Bcix nOKa3HMK0B
nporpecyBaHHA nonoris (nepemMM 3a
10 xB, onycKaHHA roniBKM Nnona), cTaHy
MaTepi(nynbc, apTepianbHMÀTUCK,TeMne
paTypa, ceya) innoga (4C, CTaH HaBKO
nonninHMX BOA, KOHO0rypauia roniBKM
nnoga) Ha gaHn 4ac.
3anvc nOKa3HMK0B NOganbworo MOH0
TOpMHry Hagani saiHcHIOETbCA B0A 4acy,
AKMMnepeHeceHO.
AKuyo xiHKaHaFxoguTb A0 nonoroBoÏ
3anH BaKTHBH0G Qasi I nepioay nonoris,
3HayeHHA po3KpuTTA WMÝKM MaTKM HaHO
CHTbCA O4pasy 6esnocepegHbo Ha liniio
yBarn.
Yac, y aKM 6yno npoBegetO BHYTP0LW
HE akyuwepCbKe A0cNigKeHHA, B0F3Ha4a
eTbCA 3n0Ba BiA BepTMKani, Ha AK0G 3Ha
XOgMTbCA HaHeceHMÝ Ha liHio yBarn X.
3anuc BC0X nOKa3HMK0B iporpecyBaHHA
nonoriB, CTaHy MaTepi Ta nnoga Hagani
3giñCHIOHOTb BÍA Lboro 4acy.
BiFxuneHHA rpapiky poskpwTTA wHÄ
KH MaTKH BIIpaBO 3a Jl0H0Io yBarn 3a Ha
ABHOCT0 yinoro nnigHoro Mixypa e abco
NIOTHMM noKasaHHAM AO npoBegeHHA
aMH0OTOM*T.
AKuyo rpapik po3KpMTTA WMMKM MaTKM
A0CArae abo nepeTMHae liHÍO gü, Heo6
XiFHo:
npOBecTU NOBHY O;IHKy CTaHy MaTepi,
noga akyuepcbKOi CMTYayii;
3a HaABHÍCTIO NOKa3aHb (AMCTpec nno
ga, kn0H04HO By3bKMýTa3, HeeeKTVB
Ha cTUMynAy0A nonorOBOi AAnbHOCT0)
npOBecTMKecapiB po3TMH;
" y pa3i nponOBKeHHA KOHCepBaTMB
HOro BeneHHA noNoriB po3104aTM
nigcuneHHA pogOBOÏ giANbHOCT0 OKCY
naBa 21. HopManbHÍ nonorM 337
 TOLMHOM, AKIO Le He Qyno 3poQneHO
paHiue.
BHyTpiLJHe akyuepcbKe A0CniFxeHHA
npoBOAATb 4epes KOKH0 AB0 ron. AKuyo He
BAanoca A0CATTM TeMny po3KpMTTA UMÝ
KM MaTKn 1CM/rog M0K PyAb-AKMMn 3UMx
A0CniKeHb (TO6TO rpapiK po3kpuTTA
wniKM MaTKM He e napanenbHMM JliHi Ai),
npoBecTMpo3poNKEHHA WNAXOM Kecape
BOrO p03TMHY.
AKuyo rpapik posKpuTTA WnÄKU MaT
KH A0CArae abo nepeTMHae Jlinio Aii, pu
3MK 0HTPaHaranbHOï 3arnQeni nnoga niA
BHULyeTbCA y 10 pasiB.
OnyckaHHA rOn0BKM nnoge
OnycKaHHA roniBKV nNOAa Bu3HayeHo
3a AonoMOrOHO aónomitbHOÏ naNbnasii
Ta/a6o BHYTp0JHbOro akyuepCbKOrO A0
ChinkeHHA.
Ha napTorpami BiAM04aeTbCA OnyCKaH
HA roniBKM, BU3HaYeHe WNAXOM aónOii
HaNbHOi nanbnaui.
Ana BM3HaYeHHA nonoKeHHA rONiBKM
Hag KpaeM Ta3a wNAXOM aóFoM0HaNbHOI
nanbnauii BMKOpMCTOByIOTb UnpMHy 5
nanbsiB.
ToniBKa nnoga BM3HaYeTbCA Hag
CMMQ03OM Ha wnpMHy 5 nanbljB aKyue
pa - 5/5.
No Mipi onyckaHHA rOn0BKM B nopoK
HMHY Taga BOHa BU3Ha4eTbCA MeHIOHO
KiNbK0CTHO NaNb0B Hag CMMOi3OM: 4/5 -
Wnpta 4 nanbjiB akyuepa, 3/5 - uuMpu
Ha 3 nanbiB aKyuepa, 2/5 - uMpMHa 2
nanbsjB akyuepa, 1/5 - wnpMHa 1nanb
IA, 0/5 - roniBKa He BV3Ha4aeTbCA Han
CUMisOM.
A6nOM0HanbHa nanbnaia gae MOKNI
B0CTb 3anobirTM nOMMNKaM y BMnaFkax,
KONn nig 4ac BHyTpiUHbOrO akywepCbKO
ro qocnigKeHHA BaKKO B0Api3HVTU onyc
KaHHA roniBKM B0A 3HaYHOro nOCuneHHA
HabpAky nepegnexayoj 4acTMHM.
338 naBa 21. HopManbH0Nonoru
Konu roniBKa naNbnye TbCA Ha 2/5 Han
BepxH0M KpaEM CMMPI3), je o3Ha4ae, uo
roniBKa BeMKIM CerMeHTOM npouna
nOey BXOAy B Ta3.
Kony roiBKananbnyeTbCA MeHW H0X
Ha 2/5, ye HaD4acTIWe O3Ha4ae, Êo roniR
Ka 3HaxouTbCA y nopoKHMH0 Tasa.
BepTMKanbHa Bicb rpau "OnyCKak
HA rOniBKM NNONa B0Foópakae KinbK0CTh
nanbuiB (B0A 0 A0 5), Ha WInpMHy AKMX rO
niBKa nNoge BM3Ha4aeTbCA Hag kpaem
CUMOi3y. Topu30HTaNbHa BICb - WKana
4acy.
OnyckaHHA roniBKM NOna BM3Haya
OTb Ta BiFMI4aBoTb Ha napTorpaMi 6e3
nocepeAHbO nepeA KoKHMM BHYTpiIH0M
akyuepCbKIM AOcniFKeHHAM.
PesynbTaTV O;IHKM onycKaHHA roniB
KM nNona BiNMI4aoTb Ha napTorpami no
3HaYKOo (0), Êo Mae 6yTU po3TaLIOBaHa
Ha nepexpecTi MIK ropn3oHTanNHO, AKa
BiFnoBinae KinbKOCT0 nanb||B, Ha wMpMHy
AKMX rONiBKy nanbiyoTb Hag kpaeM CIM
isy, Ta BepTMKanNO, AKa B0FnOB0Fae 4acy
o6CTeKeHHA.
lo3HayKn (0) 3'eAHyIOTb 6esnepepB
HOO n0HieHO, CTBOPIOHO4M rpaik onyc
KaHHA roniBKV nNog. yBVNagky, KonM
BIKOHYeTbCA nepeHoc, o3HaYKM (0) He
3'eAHyioTbCA.
No3HayKa (0) Ta no3HaYKa (X) 3aBX
AM 3HaxogaTbCA Ha ogHIM BepTHKani.
OnyckaHHA roni0BKM INOga MOKe He cno
CTepiraTVCb, noKM UMMKa MaTKM He po3
KpveTbCAnpnonnsHO Ha 7-8 CM.
lepeDMM 3a10 xB. KoxeH KBaApat no
BepTMKani BignoBiFae 1nepemMmi3a 10 xB.
lo rop3OHTani KOKeH KBagpat BignoB
Aae 30 xB. KinbKicTb iTpMBanicTb nepeMM
niApaxoBYIOTb ynpogoBx 10 XB. KinbK0CTb
nepemM 3a 10 XB - ye KinbKiCTb KBaApa
TMK0B, AKi MaroTb 6yTM 3auTpuXOBaHI no
BepTMKani BiFnOB0NHO g0 4acy o6cTeKeH
HA.
 BMA wTpMxYBaHHA 3anexTb B0A Tpu-
ro
nepeMuB CeKyHgax: ce4OBunycKaHHa
Heo6xinHiCTb (HaragykTe X0HL0 Npo
- MeHWe 20
c:
roA) Ta ce4OBMIYCKaHb KOKHI 2-4
BiFMi4aroTb
-BËq 20 n040 c; TMKani, AKa BignOBiFaeipaBopy4 BiA Bep
binok Ta aueTOH ceyi 3HaYeHHIO 4acy.
6inbwe 40 c.

KinbK0CTb TpVBanicTb nepeM BM3Ha-
yaroTb i B0AM0YaOTb Ha napTOrpaMi uo-
rOgMHM BNaTeHTHIM basi Ta koKH0 30 XB
BaKTUBH0ù pasi.
lITpMxyBaHHA 3aBXAM 3AiMCHIOeTbcg
npaBopy BIA BepTMKani, AKa BignoBinae
neBHOMY 3HaYeHHHO 4acy.
Ill- CTaH K0HKM
Ilynbc Ta aprepianbHMÝTHCK
BepTMKanbHa BICb rpapu oAHO4CHo
BiFoópaxae aptepianbHMÝTUCK Ta yacTo
Ty nynbcy.
AprepianbHMÝ THCK Ta yacToTy nynb
cy BM3Ha4akoTb Ta BigM0HaroTb Ha nap
TOrpami KOKH0 2 ron, ApTepianbHMÝTMCK
B0AMIHaHOTb Ha napTorpami ABOO04HOHO
CTpiNKOHO (nokasaHa 3niBa B0A BepTu
KanbHOÏ Oci rpau), AKa 3Bepxy noCArae
ropn3OHTani, uo BignoB0Fae 3Ha4eHHIO
CMCTON0YHOrO TMCKy, a 3HI3y - ropnsOH
Tani, uÊo BignoBilae 3HayeHHO AiacTON0Y
HOro TMCKy.
ABO6iYHa cTpiNKa Mae óyTM posTaIo
baha npaBopyy Biq BepTMKani, AKa B0Ano
BIFae 3HayeHHO 4acy.
TacToTy nynbcy BigM04aioTb Ha napTo
TpaMi no3HaKOO (-), AKa Mae 6yTM po3Ta
WOBaHa Ha nepexpecT0 M0K ropn3oHTan-
, uo BiFnoBigae 3HayeHHHO 4acTOTM
nynbcy, Ta BepTMKanno, LIo BignoB0Fae
3Ha4eHHKo 4acy. TINa BU3Ha4aoTb Ta B0A-
MI4TeMnepat
arOTb Hay pasiynapTorpaMi
py KOKHi 4rog (a60
4acTILWe HaABHOcT0 NOKasaHb) Ta
BIBIAnoBinae
AM04aroTb 3HayeHHIO
npaBopyY B0A BepTMKani,
4acy.
AKa
06eM BMAineHOÏ ceYi BV3Ha4aroTb Ta
BipMi4aoTb Ha napTorpami nicNA KOXH0-
nOkagaHHAMM. BV3Ha4aOTbCA 3a
OKCMTOL;H
3anoBHHOOTb y pasi cTMMynAsii nono
rOBO0i AiaNbHOCTi. BepxH0M pAgok rpapu
npv3HayeHMÝ AnA 3annCy g03M OKCVTO
LMHY Bpo3paxyHKy Ha 1niTp isionori4
HOro po34MHY. HKH0MPANOK rpapu npu
3Ha4eHMM ANA 3anvcy WBnAKocT0 0HOy3il
po34MHy oKcMTOLMHY. KinbKiCTb Kpanenb
OKCMTO;MHY 3a XBMNMHy 3anvcyeTbCA
KOKH030 XB.
Ilpu3HayeHi niku
3anoBHIOOTb y pasi 3acTOCYBaHHA Me
AMKaMeHT0B.
10 Kpok0B TerinoBOrO naH;IOKKa
1. Tenna nonoroBa k0MHaTa (onepa
uiMHa). NpuMiLeHHA nOBMHHe 6yTM
4MCTMM 0TennMM, Pe3 npoTAriB 3 B0A
4MHeHX B0KOH, ABepeDTa KOHAM;0o
HepiB (BeHTMNATOpiB). OnTMMaNbHOO
(6e3neyHOO) ANA MaTepi Ta AMTMHM
BBaKaeTbCA TeMnepaTYpa HaBKONMI
HbOro cepenoBua 25-28 °C.
2. HeramHe o6cyuyBaHHA AMTMHM. B
Apasy nicnA HapOAKeHHA (A0 nepepi
3aHHA nynoBMHM) akyuepka noBMH
Ha o6cyunTM Tino Ta ronOBy AMTMHM
CTepnbHUMM, CyxVMM, nonepegHbO
nigirpiTMMM neNiOWKaMM. BuKNacTM
AMTMHY Ha KnBIT MaTepi 3ak0H4MTU
06cyuiyBaHHA. BonorinenioKM Tpeóa
B0qKNacTM, OAATHyTM Ha AMTMHY 4VCT0
wano4Ky iWKapneTKM Ta HakpuTM 4Mc
TOO CyXOHO nonepeAHbo nigirpiToO
nenoIKOHO. Bce HeoóxigHe AnA 3ipi
BaHHA AMTMHM (nenioKM, wano4Ka,
LIKapneTKM, Copo4eKu, nOB3yHKM,
KOBApa) Tpeóa nigrOTYBaTM 0nigirpitu
3a3ganerigb.

naBa 21. HopManbHinonorn 339

 3. KOHTaKT "UKipa go uKipn". KOHTaKT
"UKipa Ao WKipu" 3anobirae BTpaTaM
Tenna Ta cnpuae KONOH03ayiï opraHÍ3
My AMTMHMþnopOHO MaTepi. Ha rpygaX
MaTepi AMTMHY HakpuBaoTb 4MCTOo
nonepeAHbO NigirpiTOO nenoIKOO Ta
cniNbHOHo 3 MaTip'o KOBApOo, i BOHa
3HaxogTbCA TaM 10 nepeBegeHHA
Bnanaty cninbHOro nepebyBaHHA He
MeHWe 2 rog. 3 MeTOO KOHTpono
AOTpMMaHHA 3axoniB TennOBOro naH
LUIOKKa nepwe BMMipiOBaHHA TeMnepa
Typu Tina HOBOHapoAKeHoro 3qiñCHKO
eTbCA Yepes 30 xB icNA HapopxeHHA
B aKcunApHiM AinAH0 eneKTpOHHMM
TepMOMeTpOM. MexaMu HopManbHoi
TeMnepaTypu Tna HOBOHaponKeHoro
cnig BBaxaTn 36,5-37,5 °C npu BMM0
pOBaHHÈB NaXBOB0MAM;0.
4. TpyaHe BMronoByBaHHA. TpyAHe BMro
A0BYBaHHA Tpeba no4WHaTM AKOMO
ra paHiwe, npoTArOM nepuoï rogMHM
nicna HaponkeHHA, KONM AMTMHa npo
ABNAE O3HaKn roTOBHOCT0 A0 no4T
Ky roayBaHHA inepeóyBae 3 MaTipo
BKOHTaKT0"UK0pa A0 WKipu". He Tpeba
npuMywyBaTM AMTMHY po3n04MHaTM
nepwe roAyBaHHA, AKIO BOHa He npo
ABNAE IMX O3Hak.
5. BiFknacTU 3BaKyBaHHA Ta kynaHHA. Ky
naHHA Ta 3BaKyBaHHA HOBOHapoKeHO
ro BiNpasy nicnA HapoKeHHA npM3BO
AMTb A0 BTpaT Tenna, TOMy si npoyeAypu
Tpeba BiAknacTM. KpOB Ta MeKOH0M4acT
KOBO BMmanAkoTbCA 30 UK0pMHOBOHapon
>KeHOronpu o6cyuuyBaHH0NicnA nonori.
3anUKM ponoBoi 3Ma3KM He BVganA
OTbCA y AMTMHM. lepue KynaHHA JOinb
HO 31iHCHIOBaTM BAOMa. 3BaxyBaHHA
Ta aHTpOnOMeTpiko AMTVHM Heo6xiFHo
npOBOgMTM nicnA 3giñCHeHHA KOHTakTy
"UKipa 40 WK0pu' nepen nepesengeHHAM
y nanaty crinbHOro nepebyBaHHA.
6. paBuNbHO OAATHyTM Ta 3aropHyTM Av
TMHY. Tyre cnoBVBaHHA W0gnMBe AnA
340 naBa 21. HopManbH0 NONOrM
HOBOHaponkeHoro, TOMY uo 3MeHUye
ebeKTMBHÍCTb NIATpMMaHHA Tenna Ay
TUHOKO, CKOByE pyxn nnTMHM, O6Mexye
AMxanbH0 pyxn. y 3B A3KY 3 uMM AuT
Hy HeoxiFHo oAArHyTM B4MCTÍ Tenni
nOB3YHKM, Copo4e4ky, Wano4ky, wKap
neTKM Ta HakpuTMTeinoKO KOBApOO.
7. Llinogo6OBe cninbHe nepeóyBaHHA Ma
Tepi Ta AMTMHM. 3a yMOBM BIAcyTHOCTÍ
npoTMIOKa3aHb HOBOHaponkeHa gMTV
Ha noBMHHa uinogoB nepeóyBaTM
pasOM 3 MaTipio BOAHOMy npuMiLIeHHÍ.
CrinbHe nepebyBaHHA MaTepi Ta nTU
HM 3a6esneyye ronyBaHHA Ha BMMOry,
npoinakTMKY rinoTepMi Ta npooinak
TMKY BHYTpiWHbOn0KapHAHoÍ 0H¢eksi.
8. TpaHcnopTyBaHHA B Terinnx yMOBax.
AKuo AMTMHY Tpeba TpaHCriopryBaTM
B0HWe BiNgineHHA (nanaTy), MeAvYHÍ
npaujBHVKM 3060OB'A3aH0 3abesneyMTM
nigTpuMKy Ta KOHTPoNb TeMnepatypu
TiNa nnA 3anobiraHHA BMHMKHEHHA rino
TepMi. BnanaTy cninbHOro nepebyBaH
HA HOBOHapokeHVM noBMHeH TpaHC
nopryBaTUCA pasOM 3 MaTip'o. Npn
HaponkeHHÍ AMTMHM WNAXOM Kecape
BOro po3TIHY, HOBOHapopKeHMÝ TpaHC
nopTyeTbCA B KyBe3i abo BAMTAYOMY
iKeYKy, BKpMTMMTennOo KOBApO.
9. PeaHiMaLiA BTenux yMOBax. HOBOHa
popxeHa quTUHa 3 acoikcieO He MOKe
BUpOQnATUAOCTaTHHO KibK0CTb Tenna,
y 3B'A3Ky 3 4MM nigBMyeTbCA pu3MK
BIHVKHeHHA rinOTepMI. TOMy BaKIM
BO 3abesne4MTM npoBegeHHA peaH0Ma
LIMHVX 3axoFjB y Tennnx yMOBax.
10. MigBMeHHA piBHA nigroToBKM
i 3HaHb. Bci MeAninpayiBHVKM no
BMHH0 MaTV B0gnOBiAHy nigroTOBKy
0HaBI4KM 3 npMHLMniB A0TpMMaHHA
"TennOBoro naHOKKa".
PaHHiH nicnanonoroBuH nepio - no
4MHaETbCA 3MOMeHTY BuTHaHHA nocniAy
i TpMBae 2 rog. Yyem nepiog nopoginna
 nepeóyBaTH nig peTenbHMM CnocTe-
pexeHHANM, Êo nOB''A3aHO 3 pu3MKOM BM-
HIKHeHHAnicnanonoroBO KpOBOTei.
NisniH nicnanonoroBHH nepiog - Ha-
Yepeg 2 rog nicnA nonoriB, TpuBae
CTa6
npoTArOM 6-8TMKH0B. ig 4ac nisHboro
nicnapogoBOro nepiony B0FóyBaeTbCA
3BOpOTHMADo3BITOK yCIX opraHiB Ta CMC-
3M0HUNMCA y 3B'A3Ky 3 BariTH0CTIO
TeM,AK0.
Ta nonoraMM.
nnin SK o6'cKT NOnoriB: KicTKH, WBn,
TIM'RYKa
BenuKe T0M AYKOp03TaWOByeTbCA M0K
9aFH0MM yacTMHaMM 060x NO6HMX Ta
nepegHiMM YacTMHaMM O6Ox TÈM'SHMX
KiCTOK I ABNAE CObOH0 Cnony4HOTKa
HMHHY NnacTIHKY pOM6OnogiQHoi op
MM (pMc. 21.6).
. Mane T0M'AYKO Mae opMy TpnKyTHMKa
i3HaXOgMTbCA MIK 3aFH0MM 4aCTMHaMM
o60x TÈM'AHMX Ta noTMNMYHOÏ K0CTOK.
" lepegHbO6i4H0 TÈM'AYKa 3HaxogaTbCA
M0K NOOHOHO Ta CKpOHeBOO 0KIMHONO
gióHOHO KiCTKaMM.
No6HMÀwOB
Slo60Ba K0CTKa
TiM'AHa KiCTKa
Mane TÈM'AYKO
NoTMNMYHa KiCTKa
Puc.21.6. 4epen HOBOHapoMeHoro (BMrnAA 3Bepxy)
3agHbo6i4HÍ TÍM'A4Ka - MÍK
BOHO, TÈM AHOHO Ta ioTMSMYHOHOCKpOHe
KÍCTKa
MM,
Ha ronissi pospisHAIOTb po3Mipu
iBignoBiHi oKpyKHocri(puc. 21.7,
21.8):
1. Ipamn po3Mip d. frontooccipitalis Bia
nepeHiccA A0 HañÐinbuw BMCTYniako4oi
TO4KM nNOTMSNVL0AopiBHIoe 12 CM. BiA
noB0AHO, OKpyKHÍcTb roniBKM circum
ferencia frontooccipitalis 10piBHIOe
34-35 CM.
2. BenukuÝ KOCMq po3Mip d. mento0c
cipitalis Bin níFóopignA no HañóiNbW
BiAganeHOÏ TOYKM nOTMSIMuÍ gopiBH0¬
13-13,5 CM. BignoBiAHO ÝOMYy oKpy*
HICTb A0piBHIOe 39-41 CM.
3. Mann KOCMÝ po3Mip d. suboccipito
bregmaticus Big noTMSMYHOT AMKM A0
cepenMHn BenuKoro TÈM'AYKa nopiB
HIOE 9,5 CM. BinnOBiNHO, OKpyKH0CTb
AopiBHIOe 32 CM.
4. CepegHi KOCM PO3Mip d. suboccipito
frontalis B0A noTMYHOI AMKU AO MeKI
BONOCMCTOÏ 4aCTUHM NOba A0piBHIOE
Benmke TÌM'AYKO
BiH;eBÀ uOB
.CrpinonoaiPHWàuoB
NAMPgonogióHn wOB
naBa 21, HopManbH0 nonoru 341
 1
5
2

3
Puc. 21.7. Yepen
HOBOHapaANeNOrO.
Posmip ronisKM NNOga:
1-Na KOCHÌC
2-cepegHi} KOCHC
3-nORNni,
4- BeK KOCVIC
5- BepTKanbHt

Pwc. 21.8. Yepen HOBOHapoAKe

Horo (BMTns 36oxy). OxpyxHocri
ronisxn Bi¡noaino 4o posmipis:
1-mpRM,2-Be KDCH,
3-BegTaTbH 4- Man KOon

10CM BinnosiHO, OKpyHCTb Aopie 7. Mawi nonepeH posMip d bitempo

HOE 33 CM
5 BepTvKaTbH posMip d sublingva
bregmaticus Bin cepe seKoro
TÍMÍAKa A0 insSKOBOi KiCTKI nopis
HOE 95 CM, OKDYHiCTb Ton BKOA np
LbOMy AopiBoe 32-33 CM.
6. Bens nonepeH posMp d bipa
rietalis MK HaoTbu Bnane
TOHKaMM TIMPHK TODDKB nODB0E
95 CM
rals MiK Hañbinbu BinnaneA TO-KG
MMBHesoro uBa nopiBoe 8 CML
8. TonepeHK TasoBoT ningHK dinte
trochanterica nopBHOE 9-9,5 CM. BI
noBinHo, oKpysHiCTb A0piBHOe 28 cM
9. lonepeuHK eyOBoro no9ca dbr
acromialis nopiaH0E 12 CM Opy
HCTb nO LbOMy poSMipy 35 CM
BioMexaHi3M nonoris-ue cyxyTHICTS
3TMHanbHK, OCTVTabHK Oóegra

342 Tnaea 21. Hopanbi nonorn

 npoxonKeHH0 yepes pOnOBMM Ka-
Han. 5iOMexaHi3M nonoriB BM3Ha4aeTbCA
cTpyKTypoIO K0CTOK Ta3a i3naTHICTHO ro-
niBKMA0 KOHDirypauii.
CioMexaHi3M NONoriB nph nepegHbOMy
noTHNMYHOro nepeneKaHHA CKNa-
qacTbCA34 MOMeHT0B (AVB. pMc. 21.9).
Npu noTWIMYHOMy nepennekaHHi ro
niaKa nnoAa Ao n04aTKy nonoriB TDOXM
oiTHVTa, TO6TO NOTMNMUA I Mane TiM'AYKO
HVX4I 3a BenMKe TÈM'AYKO; CTpinonoFi6-
HMÚ WOB po3MILIyeTbCA TPOXM B KOcOMy
no3Mipi B NOMHI BXOAy g0 MaNoro Tasa.
Ilepwmn MOMeHT:
" 3TMHaHHA TONIBKM;
" onycKaHHA 0T BIOLMHY BXAy A0 Ma
Noro Ta3a.
le noBopoT roniBKV HaBKONO CBO
ei nonepeHOT Oc0. BHacniFok 3rMHaHHA
roniBKM Mane T0iMg4KO po3M0LIyeTbCA Ha
HVKHBOMy nontoci nepegnernoi 4aCTMHM,
HaÑnMxaO4MCb no npoBiFHOÏ N0HIT Ta3a,
icTae "npOBiFHOO TOYKOO". Tipu 3rMHaH
HI roniBKU npoB0gHa BÌCb roniBKM 0Ta3a
CiBnaFaOTb, npu ;bOMy CTpinonogi6HMM
WOB 3HaxogMTbCA Ha piBH0M B0FCTaH0 B0A
NOHa i MMCy Kp>K0B. TaKe BCTaBNeHHA ro
NiBKM Ha3VBaeTbCA CMHKJN0TUYHMM.
BHacninoK 3rMHaHHA roNiBKa ipoxo
AMTb Yepe3Ta3 HaMeHWOHo OKpyKHICTO,
HKa npoxXogMTb 4epes ManuH KocMM po3
Mip i AopiBHIOE 32 CM. locTynanbHi pyxn
roniBKM TpMBaOTb 6esnepepBHO A0 Ha
ponKeHHA NNONa. BnpogoBX ;bOrO npo
ecy ronieKa KOHOirypyeTbCA.
ApyruHMOMeHT:
BHYTp0IHim nOBopoT roniBKU 3AiMc
HioeTbCA npu nepexogi iï 3 UMpokoi
Manoro Tasa. To
y By3bky 4acTUHY HaBKONO
DIBKa nOBoNi noBepTaeTbCA
nOBepHyTa
CBO¬Ï Oci TaK,uo noTMIMyA
KpMKOBOI
AO CMMisy, ao6nyy49- A0cipAMOBaHe
KICTKM, Mane TÈM'AYKO
A0 CMMisy, a Benvke - B60K Kpu>K0B
CTpinonogióHnHWOB
(AMB. puc. 21.10).
nocTynOBO 3M0H0e CBOe nonoxeHHA
nepexonMTb 3 nonepe4Horo po3Mipy
y KOCMÝ, noTIM 3 KOCOrO- y npaMMM
po3Mip BVXOAy Ta3a (AMB. puc. 21.11).
Crpinononi6Hn wOB npu Inosuui
npoxoFTb 4epes npaBum KOCMÝpo3Mip,
npu Il - 4epes niBMM KOCMÝ po3Mip Tasa.
BHyTpiIH0MNOBOpOT roniBKM nnoga e Ha
ciAKOM npucTocyBaHHA HamMeHIMx iï
po3MipiB A0 HaMQinbuMx p03Mip0B Tasa,
a TakoK Onopy n0CTYnanbHOMY pyxOB0 ro
niBKM 3 6OKy M'A3OBOrO anapaty Ta3a.
TpeTiM MOMeHT:
po3rMHaHHA roN0BKM B out0 B4
XOAy. CTpinononiPHMÀ WOB BCTaHOB
NoETbCA y npAMOMy posMipi BMXOAy
Tasa. YTBOPIoeTbCA TOYKa ikcasiï MiK
cepegMHOHO HMKHbOro KpaO no6KOB0
ro cUM)isy inignoTMNMHHOO AMKOO,
HaBKONO jei TO4KM 3AiMCHIOETbCA
posrMHaHHA roniBKM, IO KN0H0YHO B0g
nOB0gae Bpi3yBaHHIO Ta npopisyBaHHIO
roniBKM.
YeTBepTHö MOMeHT:
BHYTp0UH0M nOBopoT Ne4MKiB - nig
4ac Bpi3yBaHHA Ta npopisyBaHHA ro
NiBKV TynyQ npocyBaeTbCAA0 Manoro
Ta3a, nonepe4HVM po3Mip nne4MKiB
3aMae ogMH i3 KOCMX po3MipiB BXOAY
A0Manoro Taga (npu nepwi no3Mi
niBMG KOcuipo3Mip, npu ApyriA - npa
BM} KOCMApo3Mip).
Ha TasOBOMy AH0 NNeHMKa sqiñcHIO
KOTb BHYTpiWHIM nOBOpoT, no 3akiHyeHH0
AKOrO BCTaHOBNIOOTbOA npAMMM po3M0
poM y npAMOMY p03Mipi nnoLMHM BMXOAy
Tasa. LleHnOBopOT NE4MK0B NepegaeTbCA
roniBs0, AKa HapoAMnacA, o B0AnOB0gae
YeTBepTOMy MOMeHTy 6iOMexaHi3My nono
riB - 30BH0LIHbOMY nOBOp0TY roNiBKM.
foniBKa npu ybOMy obepTaeTbCA O6NM4
no3M;ii -
4AM A0 CTerHa MaTepi: nipu nepuiM epeg
A0 npaBoro, npu ApyriH - Ao niBOro. Ayry,
He nne4MKO BCTYnae niA nO6KOBy
HMKH0M
yTBOpoeTbCA TO4Ka pikcauii M0K
naBa 21. HopManbHi nOnorn 343
 1. l0 3rnagkyBaHHA WMÝKM MaTKM 5. loBHe po3rMHaHHA rONiBKM

2. 3rnaFkyBaHHA IMIKM MaTKV,

3rMHaHHA roniBKM 6.30BHIWHIÄ nOBOpoT roniBKM

3.OnyckaHHA 0BHYTpiIH0M nOBopoT roniBKM 1. HaponKeHHAnepegHboro nne4mka

4. lOBHMMnOBOpOT 0nO4aTOK
posrMHaHHA rONiBKM 8. HaponxeHHA 3agHboro nneyMKa
PHc. 21.9. bioMexaHi3M nonOriB nph nepegHbOMy BHgi noTwnwYHoro nepennekaHHA

344 TnaBa 21. HopManbHi nonorM

 1
Puc.21.10. PogoBuH KaHan (A) inpocyBanHA Nnoga no poqoBomy kaHany (B)
Pc. 21.11. CrpinonogióHMÝWOB ynpasomy KocOMy posMipi
KpaeM CMMisy Ta MICeM npMKpinneHHA
AenbTononiOHOro M'A3a no nneYOBOÏ K0CT
KM. HaBKono TOYKM )ikcaujii BiFóyBaeTbCA
STMHaHHA TynyQa BrpyAHOMy BIAAI I nep
uMM HapoNKyeTbCA 3aFHe nneyKo, noTIM
3aFHA pyyKa. licng HapogkeHHA NNeYBO
TOnOAca HaponkyroTbCA 0HI0 4aCTMHM No
Ho, HaponKeHHA AKMX He Mae cnejanbHor0
6ioMexaHi3My, OCKINbKM 0X po3Mipu 3HaYHO
MeHLIi 3a roniBKy 0nneKM.
biomexanisM NonoriB npu 3a4HbOMy BMi
ioTMNWYHoro nepegnexaHHA
lepun MOMeHT 3rMHaHHA Ioniyc
KaHHA roniBKM NNOga (He Bigpi3HAETbCA
BIA nepegHboro BUAy noTMNMYHOo ne
pegnekaHHA) (Taón. 21.2).
Apyru MOMeHT - BHYTp0IHMNOBOPOT
roniBKM NnOga noTMnMyAobepraeTbCA A0
KpuxOBO0 KicTKM, O6nvy4A 06epHeHe go
CIMO03y, Mane T0MA4KO CIpAMOBaHe B60K
KpMK0B, a Benuke- A0 CMMþ03y. CniFoM
3a noTMNMeo nOBepTaeTbCA Ha3agciMH
Ka nnona. CTpinonogióHMMWOB 4epe3 og
HO}MeHHMM 3n03MLiEHO KOCuMpo3M0p ne
pexonTb y npAMMpo3Mip BMXOAy Ta3a.
TpeT0M MOMeHT A0gaTKOBe 3TMHaH
HA rON0BKV INOga. YTBOpOETbCA nepua
TO4Ka iKcasil M0K CepenuHOHO HMKHbOro
Kpako cMMQi3y Ta AinAHKOO nepegHbOro
Tnasa 21. HopManbHi nonorM 345
 TRÐnMa 21.2. IlopieNAHHA 6iOMexaHisMy nonoriB ipn nepeFHbOMy Ta 3aFHb OMy BMgax noru.
nMHOrO nepegnexaHHA

O3naKa nepeanii oHA 3agniM BWA

tpoeia TOVKa Mane t0M'ayKo CepeguHa M0X ManMM Ta BenMKMM TÍM'AYKaMM
Jinia opieHTMp Crpinonogi6HM woB CrpinonogibHn woB
MOMeHTW |-3rMHaHHA roniBKM; |- HenOBHe 3rMHaHHA rOn0BKM;
6iOMexaN0sMy
nOnoria
I|-BHYTPiwH0M noBopoT ro
niBKM nOTMNM;ei0 AonepeAY;
I| - BHYTpiwHi0M noBOpOT roniBKM nOTMNMuero
A03aAy;
I|l- posrMHaHHA roiBKV; IIl- A0AaTKOBe 3rMHaHHA roniBKM;
IV- BHYTpiwH0M nOBOpOT II|- po3rMHaHHA roniBKM;
nnemkiB, 30BH0WH0MnoBopOT V- BHYTp0WH0ä noBopoT nneynkiB, 30BHÍWHÍÄ
roniBKM noBopoT roniBKM

Towka þikcaui 1- nignoTWNMYHa AMKa, 1- Mexa BONOCMCTOÏ 4acTMHM roniBKV, n06KO

noóKOBa Ayra Ba Ayra,
2- nign0TMNMYHa AMKa, KpMKOB0-KypuKoBn
cyrno6

Kpako BenMKoro TÌM'AYKa (Mexa Bonocu 'aTHG MOMeHT He Bigpi3HAETbCA BÍg

CTOI YaCTVHM rOnOBM), HaBKONO AKOÏ B0A
6ysaeTbCAAOgaTKOBe 3rMHaHHA, AKe TpM
sas Ao yTBopeHHA Apyroi TOYKM þikcaui.
YeTBepTHÀ MOMeHT posrMHaHHA
roniBKA. NpopisyBaHHA roniBKM B0FbyBa
STbCA BHacninOK posrMHaHHA roniBKM
AOBKONa Apyroi TO4KM ikcauii M0K nigno
TWNMHHOO AMKOKO 0BepxiBKOKO Kynpuka.
ToniBKa HaponkyeTbCA NMIeM Ao CUMO0
sy, npopisyeTbCA TpOxM6inbWOO OKpyx
HICTIO NO cepegHbOMy KOCOMy po3Mipy.
yeTBepTOro MOMeHTY 6iOMexaHi3My no
noriB npM nepenHbOMy BVAi noTMNMYHoro
nepeneKaHHA.
Oco6nMB0CT0 KI0H0YHOrO nepeóiry no
noriB npu noTHNuYHOMY epeneaHH0
3agHboro BIgy: 6inba TpMBanicTb non0
rOBOro aKTy, H0K npu nepeAHbOMY BMgi
nOTMNMYHOrO nepeneKaHHA; 6inbwa
BMTpaTa nonoroBVX CMN ANA HagMipHOro
3rMHaHHA roniBKV; 4acTÍWe BMHMKaiOTb
pospvBn npOMeKMHM, BTODVHHacnaóKícTb
nonoroBoi gianbHOcT0, AVCTpec nnona.

PexOMeHÒoBAHa A0mepamypa
1. AKywepcTBO Ta iHeKONoria: y4 T.: HauioHaNbHMH nigpyYHIK / Kon.aBTOD0B., 3a peg. akag HAMH
YkpaiHu. npod. 3anopoK•Ha. - T1. AKywepcTBO,2013. 1032 c.
2. BackerT I 0, Kangep 9. A., ApynkymapaH C. OnepatHBHOe akyuwepcTBO MaHpo Keppa, noA peg.
P 3ncuBepa. M, 2015.
3. Management of Spontaneous Labour at Term in Healthy Women. SOGC clinical practice guideline.
JOGC. 2016; 38 (9): 843-865. DOl:https:/doi. org/10.1016/jjogc.2016.04. 093.
4 WHO Library Cataloguing-in-Publication Data. WHO recommendations for augmentation of labour.
World Health Organization 2014.
5. WHO Library Cataloguing-in-Publication Data. Pregnancy childbirth, postpartum and newborn care a
quide for essential practice - 3rd ed. World Health Organization. World Health Organization, 2015.

346 TnaBa 21. HopManbH0 Nonorn