‫ﺑﻪ ﻧﺎﻡ ﺧﺪﺍﻭﻧﺪ ﻟﻮﺡ ﻭ ﻗﻠﻢ‬

‫ﺣﻘﻴﻘﺖ ﻧﮕﺎﺭ ﻭﺟﻮﺩ ﻭ ﻋﺪﻡ‬

 ‫ﻛﺎﺭﮔﺎﻩ ﻳﻚ ﺭﻭﺯﻩ ﭘﺎﺭﺗﻮﮔﺮﺍﻑ‬

‫ﻓﺮﺯﺍﻧﻪ ﺻﺎﺑﺮﻱ‬
‫ﻋﻀﻮ ﻫﻴﺌﺖ ﻋﻠﻤﯽ ﺩﺍﻧﺸﮑﺪﻩ ﭘﺮﺳﺘﺎﺭی ﻭ ﻣﺎﻣﺎﻳﯽ‬
‫ﺩﺍﻧﺸﮕﺎﻩ ﻋﻠﻮﻡ ﭘﺰﺷﮑﯽ ﮐﺎﺷﺎﻥ‬
 ‫ﺍﻫﺪﺍﻑ ﻛﺎﺭﮔﺎﻩ‬
‫• ﺑﺪﻧﺒﺎﻝ ﺍﻳﻦ ﻛﺎﺭﮔﺎﻩ ﺷﺮﻛﺖ ﻛﻨﻨﺪﮔﺎﻥ ﺑﺎﻳﺪ ﻗﺎﺩﺭ ﺑﺎﺷﻨﺪ‪:‬‬
‫‪ -1‬ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﺭﺍ ﺗﻌﺮﻳﻒ ﻛﻨﻨﺪ‪.‬‬
‫‪ -2‬ﻣﻌﺎﻳﻨﺎﺕ ﺭﺍ ﺩﻗﻴﻘ ًﺎ ﺑﺮ ﺭﻭﻱ ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﺛﺒﺖ ﻧﻤﺎﻳﻨﺪ‪.‬‬
‫‪ -3‬ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﺭﺍ ﺗﻔﺴﻴﺮ ﻧﻤﺎﻳﻨﺪ‪.‬‬
‫‪ -4‬ﻫﺮﮔﻮﻧﻪ ﺍﻧﺤﺮﺍﻑ ﺍﺯ ﻣﺴﻴﺮ ﻃﺒﻴﻌﻲ ﺭﺍ ﺗﺸﺨﻴﺺ ﺩﻫﻨﺪ‪.‬‬
‫‪ -5‬ﭘﻴﺸﺮﻓﺖ ﺯﺍﻳﻤﺎﻥ ﺭﺍ ﻛﻨﺘﺮﻝ ﻧﻤﻮﺩﻩ ﻭ ﺩﺭ ﺯﻣﺎﻥ ﻣﻨﺎﺳﺐ ﺩﺧﺎﻟﺖ ﻛﻨﻨﺪ‪.‬‬
‫‪ -6‬ﺍﺭﺯﺵ ﻭ ﺍﻫﻤﻴﺖ ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﺭﺍ ﺑﺮﺍﻱ ﻣﺎﺩﺭ ﻭ ﺩﻳﮕﺮ ﺍﻋﻀﺎﻱ ﺗﻴﻢ‬
‫ﭘﺰﺷﻜﻲ ﺗﻮﺿﻴﺢ ﺩﻫﻨﺪ‪.‬‬
 ‫ﻣﺪﻝ ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﺳﺎﺯﻣﺎﻥ ﺑﻬﺪﺍﺷﺖ ﺟﻬﺎﻧﻲ‬
‫‪ ‬ﺍﻳﻦ ﻧﻤﻮﺩﺍﺭ ﺩﺭ ﺩﺳﺎﻣﺒﺮ ‪ 1971‬ﺑﻪ ﻋﻨﻮﺍﻥ ﺟﺰﻳﻲ ﺍﺯ ﺍﺩﺍﺭﻩ ﻓﻌﺎﻝ ﺯﺍﻳﻤﺎﻥ ﻣﻌﺮﻓﻲ ﮔﺮﺩﻳﺪ‪.‬‬

‫ﺩﺭ ﺳﺎﻝ ‪ 1980‬ﺳﺎﺯﻣﺎﻥ ﺑﻬﺪﺍﺷﺖ ﺟﻬﺎﻧﻲ ﺑﺮﺍﻱ ﭘﻴﺸﮕﻴﺮﻱ ﺍﺯ ﻃﻮﻻﻧﻲ ﺷﺪﻥ ﺯﺍﻳﻤﺎﻥ‪،‬‬

‫ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﺭﺍ ﺑﺮﺍﻱ ﺍﺳﺘﻔﺎﺩﻩ ﺩﺭ ﻛﺸﻮﺭﻫﺎﻱ ﺩﺭ ﺣﺎﻝ ﺗﻮﺳﻌﻪ ﻣﻌﺮﻓﻲ ﻧﻤﻮﺩ‪.‬‬

‫‪ ‬ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﻧﻤﻮﺩﺍﺭﻱ ﺳﺎﺩﻩ‪ ،‬ﻣﺮﻛﺐ ﻭ ﺍﺭﺯﺍﻥ ﺑﻮﺩﻩ ﻛﻪ ﺑﻪ ﻋﻨﻮﺍﻥ ﺑﻬﺘﺮﻳﻦ ﺍﺑﺰﺍﺭ ﭘﺎﻳﺶ ﻭ ﺛﺒﺖ‬

‫ﺳﻴﺮ ﺯﺍﻳﻤﺎﻥ ﻭ ﺳﻼﻣﺘﻲ ﻣﺎﺩﺭ ﻭ ﺟﻨﻴﻦ ﻭ ﺍﻗﺪﺍﻣﺎﺕ ﺩﺍﺭﻭﻳﻲ ﺍﻧﺠﺎﻡ ﺷﺪﻩ ﺑﺮﺍﻱ ﻣﺎﺩﺭ ﺷﻨﺎﺧﺘﻪ‬

‫ﺷﺪﻩ ﺍﺳﺖ ﻭ ﺑﻪ ﻣﺎﻣﺎ ﺍﺟﺎﺯﻩ ﻣﻴﺪﻫﺪ ﺟﺰﻳﻴﺎﺕ ﺯﺍﻳﻤﺎﻥ ﺭﺍ ﺑﻪ ﺻﻮﺭﺕ ﺗﺼﻮﻳﺮﻱ ﻧﻤﺎﻳﺶ ﺩﻫﺪ‪.‬‬

‫‪ ‬ﺛﺒﺖ ﺍﻳﻦ ﻧﻤﻮﺩﺍﺭ ﺍﺯ ﺟﻤﻠﻪ ﻣﻬﺎﺭﺗﻬﺎﻱ ﺣﻴﺎﺕ ﺑﺨﺶ ﺑﺮﺍﻱ ﻣﺎﻣﺎ ﻣﺤﺴﻮﺏ ﻣﻲ ﺷﻮﺩ‪.‬‬
‫‪ ‬ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﻳﻚ ﺳﻴﺴﺘﻢ ﺍﺧﻄﺎﺭﺩﻫﻨﺪﻩ ﺯﻭﺩﻫﻨﮕﺎﻡ ﺍﺳﺖ ﻛﻪ ﺑﻪ ﺗﺼﻤﻴﻢ‬
‫ﮔﻴﺮﻱ ﺩﺭ ﺍﺭﺟﺎﻉ ﺑﻪ ﻣﻮﻗﻊ ﻣﺎﺩﺭ‪ ،‬ﺗﺴﺮﻳﻊ ﺯﺍﻳﻤﺎﻥ ﻭ ﺧﺘﻢ ﺣﺎﻣﻠﮕﻲ ﻛﻤﻚ‬
‫ﻣﻴﻜﻨﺪ‪.‬‬
‫‪ ‬ﺍﻳﻦ ﻧﻤﻮﺩﺍﺭ ﺳﺒﺐ ﺍﻓﺰﺍﻳﺶ ﻛﻴﻔﻴﺖ ﻭ ﻧﻈﻢ ﻣﻌﺎﻳﻨﺎﺕ ﺟﻨﻴﻦ ﻭ ﻣﺎﺩﺭ ﺩﺭ‬
‫ﻃﻲ ﺯﺍﻳﻤﺎﻥ ﻣﻴﺸﻮﺩ ﻭ ﻣﺸﻜﻼﺕ ﻫﺮ ﻛﺪﺍﻡ ﺭﺍ ﺳﺮﻳﻌ ًﺎ ﺗﺸﺨﻴﺺ ﻣﻴﺪﻫﺪ‪.‬‬
‫‪ ‬ﺍﻳﻦ ﺍﺑﺰﺍﺭ ﺑﺮﺍﻱ ﺍﺭﺯﻳﺎﺑﻲ ﺯﺍﻳﻤﺎﻧﻬﺎﻳﻲ ﻛﻪ ﺩﺭ ﻣﻨﺰﻝ ﺍﻧﺠﺎﻡ ﻣﻴﺸﻮﺩ ﻧﻴﺰ‬
‫ﺑﺴﻴﺎﺭ ﻣﻔﻴﺪ ﺍﺳﺖ‪.‬‬
‫‪ ‬ﻧﻜﺘﻪ‪ :‬ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﺍﺑﺰﺍﺭﻱ ﺑﺮﺍﻱ ﺍﺩﺍﺭﻩ ﺯﺍﻳﻤﺎﻥ ﺍﺳﺖ ﻳﻌﻨﻲ ﺑﻪ ﺗﻌﻴﻴﻦ‬
‫ﻋﻮﺍﻣﻞ ﺧﻄﺮﺯﺍ ﻗﺒﻞ ﺍﺯ ﺷﺮﻭﻉ ﺯﺍﻳﻤﺎﻥ ﻛﻤﻜﻲ ﻧﻤﻴﻜﻨﺪ ﻭ ﺗﻨﻬﺎ ﺯﻣﺎﻧﻲ‬
‫ﻣﻴﺘﻮﺍﻧﺪ ﻣﻮﺭﺩ ﺍﺳﺘﻔﺎﺩﻩ ﻗﺮﺍﺭ ﮔﻴﺮﺩ ﻛﻪ ﻟﺰﻭﻣﻲ ﺑﻪ ﺍﻧﺠﺎﻡ ﺍﻗﺪﺍﻡ ﻓﻮﺭﻱ‬
‫ﻭﺟﻮﺩ ﻧﺪﺍﺷﺘﻪ ﺑﺎﺷﺪ‪.‬‬
 ‫ﻫﺮ ﻣﺎﺩﺭ ﺑﺮﮔﻪ ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﻣﺨﺼﻮﺹ ﺧﻮﺩ ﺭﺍ ﺩﺍﺭﺩ ﻭ‬
‫ﻋﺎﻣﻞ ﺯﺍﻳﻤﺎﻥ ﻣﻮﻇﻒ ﺍﺳﺖ ﺍﺯ ﺯﻣﺎﻥ ﺷﺮﻭﻉ ﻓﺎﺯ ﻓﻌﺎﻝ ﺗﺎ‬
‫ﭘﺎﻳﺎﻥ ﻣﺮﺣﻠﻪ ﺍﻭﻝ ﺯﺍﻳﻤﺎﻥ ﺁﻥ ﺭﺍ ﺗﻜﻤﻴﻞ ﻛﻨﺪ‪.‬‬
‫ﻓﻮﺍﻳﺪ ﻛﺎﺭﺑﺮﺩ ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﺭﺍ ﻣﻴﺘﻮﺍﻥ ﺑﻪ ﺷﺮﺡ ﺫﻳﻞ ﺍﻋﻼﻡ ﻧﻤﻮﺩ‪:‬‬

‫‪ – 1‬ﺗﺸﺨﻴﺺ ﺯﻭﺩﺭﺱ ﻋﻮﺍﺭﺽ ﺯﺍﻳﻤﺎﻧﻲ‬

‫‪ – 2‬ﻛﻤﻚ ﺑﻪ ﻫﻤﺎﻫﻨﮕﻲ ﺑﻴﻦ ﺧﺪﻣﺎﺕ ﺍﻋﻀﺎء ﮔﺮﻭﻩ ﺩﺭﻣﺎﻧﻲ ﻭ ﺍﻧﺘﻘﺎﻝ ﻣﺆﺛﺮ‬
‫ﺍﻃﻼﻋﺎﺕ‬
‫‪ – 3‬ﺗﺸﺨﻴﺺ ﺯﻣﺎﻥ ﺻﺤﻴﺢ ﺍﺭﺟﺎﻉ ﻭ ﺍﺭﺗﻘﺎء ﻣﺮﺍﻗﺒﺘﻬﺎﻱ ﻣﺎﻣﺎﻳﻲ ﺣﻴﻦ ﺯﺍﻳﻤﺎﻥ‬
‫‪ – 4‬ﺗﺴﻬﻴﻞ ﺑﺮﻧﺎﻣﻪ ﺭﻳﺰﻱ ﻣﺪﺍﻭﻡ ﻣﺮﺍﻗﺒﺘﻲ‬
‫‪ – 5‬ﻛﺎﻫﺶ ﻣﺮگ ﻭ ﻣﻴﺮ ﻭ ﻋﻮﺍﺭﺽ ﻣﺎﺩﺭﻱ – ﻧﻮﺯﺍﺩﻱ‬
‫‪ – 6‬ﻛﺎﻫﺶ ﻃﻮﻝ ﻣﺪﺕ ﺯﺍﻳﻤﺎﻥ ﻭ ﺗﻌﺪﺍﺩ ﺗﻮﺷﻬﻬﺎﻱ ﻭﺍژﻳﻨﺎﻝ‬
‫‪ – 7‬ﻛﺎﻫﺶ ﻣﻴﺰﺍﻥ ﻣﺼﺮﻑ ﺍﻛﺴﻲ ﺗﻮﺳﻴﻦ ﻭ ﻃﻮﻝ ﻣﺪﺕ ﺍﻟﻘﺎء ﺯﺍﻳﻤﺎﻥ‬
‫‪ – 8‬ﻛﺎﻫﺶ ﺧﺴﺘﮕﻲ ﻣﺎﺩﺭ ﺑﻪ ﺩﻟﻴﻞ ﺣﻤﺎﻳﺖ ﻣﺪﺍﻭﻡ‬
‫‪ – 9‬ﺛﺒﺖ ﻣﻨﺎﺳﺐ ﺍﻃﻼﻋﺎﺕ ﻭ ﮔﺰﺍﺭﺵ ﻛﺘﺒﻲ ﻣﺎﻣﺎ ﺩﺭ ﻣﻮﺭﺩ ﺭﺧﺪﺍﺩ ﺯﺍﻳﻤﺎﻥ‪،‬‬
‫ﺩﻓﺎﻉ ﺧﻮﺑﻲ ﺑﺮﺍﻱ ﻣﺎﻣﺎ ﻭ ﺳﻨﺪ ﭘﻴﮕﻴﺮﻱ ﺗﺪﺍﻭﻡ ﻣﺮﺍﻗﺒﺖ ﺍﺯ ﺯﺍﺋﻮ‬
 ‫ﺍﺟﺰﺍء ﭘﺎﺭﺗﻮﮔﺮﺍﻑ‬
‫• ﻫﺮ ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﺍﺯ ﺳﻪ ﺟﺰء ﻣﻬﻢ ﺗﺸﻜﻴﻞ ﺷﺪﻩ ﺍﺳﺖ ﻛﻪ‬
‫ﻣﺸﺎﻫﺪﺍﺕ ﻭ ﻣﻮﺍﺭﺩ ﺛﺒﺖ ﺷﺪﻩ ﺩﺭ ﺁﻥ ﺑﻪ ﺗﺮﺗﻴﺐ ﺫﻳﻞ ﻣﻴﺒﺎﺷﺪ‪:‬‬
‫‪ – ١‬ﻭﺿﻌﻴﺖ ﺳﻼﻣﺘﯽ ﺟﻨﻴﻦ‬
‫• ﺿﺮﺑﺎﻥ ﻗﻠﺐ ﺟﻨﻴﻦ‬
‫• ﭘﺮﺩﻩ ﻫﺎﻱ ﺟﻨﻴﻨﻲ ﻭ ﻣﺎﻳﻊ ﺁﻣﻨﻴﻮﺗﻴﻚ‬
‫• ﻣﻮﻟﺪﻳﻨﮓ ﺳﺮﺟﻨﻴﻦ‬
 ‫• ﻧﻜﺘﻪ ‪:1‬‬
‫ﺩﺭ ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﻣﺪﻝ ﺍﻳﺮﺍﻧﻲ ﻫﺮ ﻣﺮﺑﻊ ﻛﻮﭼﻚ ﻧﺸﺎﻧﻪ ﻧﻴﻢ ﺳﺎﻋﺖ‬
‫ﺍﺳﺖ‪.‬‬

‫• ﻧﻜﺘﻪ ‪:2‬‬
‫ﻋﻼﻣﺖ ﮔﺬﺍﺭﻱ ﻫﺎ ﺑﺎﻳﺪ ﺑﺮ ﺭﻭﻱ ﺧﻄﻮﻁ ﺍﻧﺠﺎﻡ ﺷﻮﺩ‪.‬‬
 ‫ﺿﺮﺑﺎﻥ ﻗﻠﺐ ﺟﻨﻴﻦ‬
‫• ﺑﻬﺘﺮﻳﻦ ﺯﻣﺎﻥ ﮔﻮﺵ ﺩﺍﺩﻥ ﺿﺮﺑﺎﻥ ﻗﻠﺐ ﺟﻨﻴﻦ‪،‬‬
‫ﺑﻼﻓﺎﺻﻠﻪ ﺑﻌﺪ ﺍﺯ ﺍﺗﻤﺎﻡ ﺍﻧﻘﺒﺎﺿﺎﺕ ﺭﺣﻢ ﺍﺳﺖ‪.‬‬
‫• ﺳﻤﻊ ﺿﺮﺑﺎﻥ ﻗﻠﺐ ﺣﺘﻲ ﺍﻻﻣﻜﺎﻥ ﺑﺎﻳﺪ ﻃﻲ ﻳﻚ ﺩﻗﻴﻘﻪ‬
‫ﺩﺭ ﺣﺎﻟﻴﻜﻪ ﻣﺎﺩﺭ ﺩﺭ ﻭﺿﻌﻴﺖ ﺧﻮﺍﺑﻴﺪﻩ ﺑﻪ ﭘﻬﻠﻮ ﻗﺮﺍﺭ‬
‫ﺩﺍﺭﺩ‪ ،‬ﺻﻮﺭﺕ ﮔﻴﺮﺩ‪.‬‬
‫• ﺿﺮﺑﺎﻥ ﻗﻠﺐ ﺟﻨﻴﻦ ﺩﺭ ﺍﺑﺘﺪﺍﻱ ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﻫﺮ ﻧﻴﻢ‬
‫ﺳﺎﻋﺖ ﺛﺒﺖ ﻣﻲ ﺷﻮﺩ‪.‬‬
‫ﻣﺪﻝ ﺟﻬﺎﻧﻲ‬
‫‪ ‬ﺩﺭ ﺻﻮﺭﺗﻲ ﻛﻪ ﺿﺮﺑﺎﻥ ﻗﻠﺐ ﺟﻨﻴﻦ ﻏﻴﺮ ﻃﺒﻴﻌﻲ ﺑﺎﺷﺪ‪ ،‬ﺑﺎﻳﺪ ﻫﺮ‬
‫‪ 15‬ﺩﻗﻴﻘﻪ ﺑﻪ ﻣﺪﺕ ﻳﻚ ﺩﻗﻴﻘﻪ ﺑﻼﻓﺎﺻﻠﻪ ﺑﻌﺪ ﺍﺯ ﺍﻧﻘﺒﺎﺿﺎﺕ‬
‫ﺛﺒﺖ ﺷﻮﺩ‪.‬‬
‫‪ ‬ﺩﺭ ﺻﻮﺭﺗﻴﻜﻪ ﺍﻳﻦ ﺿﺮﺑﺎﻥ ﺩﺭ ﺳﻪ ﻧﻮﺑﺖ ﻏﻴﺮ ﻃﺒﻴﻌﻲ ﺑﺎﺷﺪ‪،‬‬
‫ﺑﺎﻳﺪ ﺩﺭ ﺍﻣﺮ ﺯﺍﻳﻤﺎﻥ ﺩﺧﺎﻟﺖ ﻛﺮﺩ ﻣﮕﺮ ﺍﻳﻨﻜﻪ ﺯﺍﻳﻤﺎﻥ ﻗﺮﻳﺐ‬
‫ﺍﻟﻮﻗﻮﻉ ﺑﺎﺷﺪ‪.‬‬
‫ﻣﺪﻝ ﺍﻳﺮﺍﻧﻲ‬
‫• ﺿﺮﺑﺎﻥ ﻃﺒﻴﻌﻲ ﺑﻴﻦ ‪ 110‬ﺗﺎ ‪ 160‬ﺑﺎﺭ ﺩﺭ ﺩﻗﻴﻘﻪ ﺍﺳﺖ ﻛﻪ ﺩﺭ‬
‫ﻧﻤﻮﺩﺍﺭ ﺍﻳﻦ ﺩﻭ ﺧﻂ ﺗﻴﺮﻩ ﺗﺮ ﻛﺸﻴﺪﻩ ﺷﺪﻩ ﺗﺎ ﻣﺤﺪﻭﺩﻩ ﻃﺒﻴﻌﻲ‬
‫ﻣﺸﺨﺺ ﮔﺮﺩﺩ ‪.‬‬
‫• ﺩﺭﺻﻮﺭﺗﻲ ﻛﻪ ﻣﻨﺤﻨﻲ ﺍﺯ ﺑﻴﻦ ﺍﻳﻦ ﺧﻄﻮﻁ ﺧﺎﺭﺝ ﺷﻮﺩ ﺑﺮ‬
‫ﺍﺳﺎﺱ ﺭﺍﻫﻨﻤﺎﻱ ﻛﺸﻮﺭﻱ ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﺩﻭﺳﺘﺪﺍﺭ ﻣﺎﺩﺭ‪ ،‬ﺗﺴﺖ‬
‫ﻫﺎﻱ ﺍﺭﺯﻳﺎﺑﻲ ﺳﻼﻣﺖ ﺟﻨﻴﻦ ﺍﻧﺠﺎﻡ ﻣﻲ ﺷﻮﺩ‪.‬‬
 ‫ﻓﺎﺯ ﻧﻬﻔﺘﻪ‬
‫‪‬ﻓﺎﺯ ﻧﻬﻔﺘﻪ ﻏﻴﺮ ﺑﺴﺘﺮﻱ‬
‫‪‬ﻓﺎﺯ ﻧﻬﻔﺘﻪ ﺑﺴﺘﺮﻱ‬
 ‫ﻓﺎﺯ ﻧﻬﻔﺘﻪ ﻏﻴﺮ ﺑﺴﺘﺮﻱ‬
‫‪‬ﻣﺮﺍﻗﺒﺖ ﺍﺯ ﻣﺎﺩﺭ ﺑﻪ ﻣﺪﺕ ‪ 2-8‬ﺳﺎﻋﺖ‪:‬‬
‫‪‬ﺍﺭﺯﻳﺎﺑﻲ ﻋﻼﺋﻢ ﺣﻴﺎﺗﻲ ﻫﺮ ‪ 4‬ﺳﺎﻋﺖ ﻳﻜﺒﺎﺭ‬
‫• ﻓﺸﺎﺭ ﺧﻮﻥ ‪ 140/90‬ﻳﺎ ﺑﺎﻻﺗﺮ ﺩﺭ ﻓﺎﺻﻠﻪ ﺑﻴﻦ ﺍﻧﻘﺒﺎﺿﺎﺕ ﻓﺸﺎﺭﺧﻮﻥ‬
‫ﺑﺎﻻ ﻣﺤﺴﻮﺏ ﻣﻲ ﺷﻮﺩ‪.‬‬
‫• ﺗﻌﺪﺍﺩ ﻃﺒﻴﻌﻲ ﻧﺒﺾ ‪ 60-100‬ﺑﺎﺭ ﺩﺭ ﺩﻗﻴﻘﻪ ﺍﺳﺖ‪.‬‬
‫• ﺩﺭﺟﻪ ﺣﺮﺍﺭﺕ )‪ 3-5‬ﺩﻗﻴﻘﻪ ﺍﺯ ﻃﺮﻳﻖ ﺯﻳﺮ ﺯﺑﺎﻧﻲ( ﺑﻴﺶ ﺍﺯ ‪ 38‬ﺗﺐ‬
‫ﺩﺭ ﻧﻈﺮ ﮔﺮﻓﺘﻪ ﻣﻲ ﺷﻮﺩ‪.‬‬
‫• ﺗﻌﺪﺍﺩ ﻃﺒﻴﻌﻲ ﺗﻨﻔﺲ ‪ 16-20‬ﺑﺎﺭ ﺩﺭ ﺩﻗﻴﻘﻪ ﺍﺳﺖ‪.‬‬
 ‫‪‬ﺍﺭﺯﻳﺎﺑﻲ ﺍﻧﻘﺒﺎﺿﺎﺕ ﺭﺣﻢ ﻫﺮ ‪ 4‬ﺳﺎﻋﺖ ﻳﻜﺒﺎﺭ‬
‫‪‬ﺍﺭﺯﻳﺎﺑﻲ ﺻﺪﺍﻱ ﻗﻠﺐ ﺟﻨﻴﻦ ﻫﺮ ‪ 4‬ﺳﺎﻋﺖ ﻳﻜﺒﺎﺭ‬
‫)ﺑﻴﻦ ‪ 110-160‬ﺑﺎﺭ ﺩﺭ ﺩﻗﻴﻘﻪ ﺑﺎ ﺍﻟﮕﻮﻱ ﻃﺒﻴﻌﻲ ﻧﺮﻣﺎﻝ‬
‫ﻣﺤﺴﻮﺏ ﻣﻲ ﺷﻮﺩ(‪.‬‬
 ‫ﻓﺎﺯ ﻧﻬﻔﺘﻪ ﻏﻴﺮ ﺑﺴﺘﺮﻱ‬
‫• ﺩﺭ ﺻﻮﺭﺕ ﺍﻧﻘﺒﺎﺿﺎﺕ ﻧﺎﻣﻨﻈﻢ ﺭﺣﻤﻲ ﻭ ﺿﺮﺑﺎﻥ ﻃﺒﻴﻌﻲ ﻗﻠﺐ‬
‫ﺟﻨﻴﻦ‪:‬‬
‫‪ -‬ﺍﻧﺠﺎﻡ ﺗﺴﺖ ‪ NST‬ﺑﻪ ﻣﺪﺕ ‪ 20‬ﺩﻗﻴﻘﻪ‬
‫‪ -‬ﭘﺲ ﺍﺯ ﺛﺒﺖ ﺩﻗﻴﻖ ﺍﻧﻘﺒﺎﺿﺎﺕ ﺭﺣﻢ ﻭ ﺿﺮﺑﺎﻥ ﻗﻠﺐ ﺟﻨﻴﻦ‪ ،‬ﺍﺟﺎﺯﻩ ﺑﻪ ﻣﺎﺩﺭ‬
‫ﺑﺮﺍﻱ ﺗﺮﻙ ﺑﻴﻤﺎﺭﺳﺘﺎﻥ‪ ،‬ﻣﺸﺮﻭﻁ ﺑﻪ ﺍﻳﻨﻜﻪ ﺑﺘﻮﺍﻧﺪ ﺧﻮﺩ ﺭﺍ ﺑﻪ ﻣﻮﻗﻊ ﺑﻪ‬
‫ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﺑﺮﺳﺎﻧﺪ‪.‬‬
‫‪ -‬ﺁﻣﻮﺯﺵ ﻋﻼﺋﻢ ﺧﻄﺮ ﺑﻪ ﻣﺎﺩﺭ ﻭ ﻫﻤﺮﺍﻩ ﺍﻭ ﻗﺒﻞ ﺍﺯ ﺗﺮﺧﻴﺺ‬
‫• ﺩﺭ ﺻﻮﺭﺕ ﻣﻨﻈﻢ ﺑﻮﺩﻥ ﺍﻧﻘﺒﺎﺿﺎﺕ ﺭﺣﻤﻲ ﺑﻮﺩﻥ‪ ،‬ﺍﻧﺠﺎﻡ ﺗﺴﺖ‬
‫‪ NST‬ﺑﻪ ﻣﺪﺕ ‪ 20‬ﺩﻗﻴﻘﻪ‪ ،‬ﺑﺴﺘﺮﻱ ﻭ ﺍﺩﺍﻣﻪ ﻣﺮﺍﻗﺒﺘﻬﺎ‬
 ‫ﻓﺎﺯ ﻧﻬﻔﺘﻪ ﺑﺴﺘﺮﻱ‬
‫‪‬ﻓﺸﺎﺭ ﺧﻮﻥ‪ ،‬ﻧﺒﺾ ﻭ ﺗﻨﻔﺲ ﻫﺮ ﻳﻚ ﺳﺎﻋﺖ ﻳﻜﺒﺎﺭ‬
‫• ﻓﺸﺎﺭ ﺧﻮﻥ ‪ 140/90‬ﻳﺎ ﺑﺎﻻﺗﺮ ﺩﺭ ﻓﺎﺻﻠﻪ ﺑﻴﻦ ﺍﻧﻘﺒﺎﺿﺎﺕ ﻓﺸﺎﺭﺧﻮﻥ‬
‫ﺑﺎﻻ ﻣﺤﺴﻮﺏ ﻣﻲ ﺷﻮﺩ‪.‬‬
‫‪‬ﺩﺭﺟﻪ ﺣﺮﺍﺭﺕ ﻫﺮ ‪ 4‬ﺳﺎﻋﺖ )ﺩﺭ ﺻﻮﺭﺕ ﭘﺎﺭﮔﻲ ﻛﻴﺴﻪ ﺁﺏ ﺑﻴﺶ‬
‫ﺍﺯ ‪ 6‬ﺳﺎﻋﺖ‪ ،‬ﺩﺭﺟﻪ ﺣﺮﺍﺭﺕ ﻫﺮ ﻳﻜﺴﺎﻋﺖ ﻛﻨﺘﺮﻝ ﺷﻮﺩ(‪.‬‬
‫• ﺗﻌﺪﺍﺩ ﻃﺒﻴﻌﻲ ﻧﺒﺾ ‪ 60-100‬ﺑﺎﺭ ﺩﺭ ﺩﻗﻴﻘﻪ ﺍﺳﺖ‪.‬‬
‫• ﺩﺭﺟﻪ ﺣﺮﺍﺭﺕ )‪ 3-5‬ﺩﻗﻴﻘﻪ ﺍﺯ ﻃﺮﻳﻖ ﺯﻳﺮ ﺯﺑﺎﻧﻲ( ﺑﻴﺶ ﺍﺯ ‪ 38‬ﺗﺐ‬
‫ﺩﺭ ﻧﻈﺮ ﮔﺮﻓﺘﻪ ﻣﻲ ﺷﻮﺩ‪.‬‬
‫• ﺗﻌﺪﺍﺩ ﻃﺒﻴﻌﻲ ﺗﻨﻔﺲ ‪ 16-20‬ﺑﺎﺭ ﺩﺭ ﺩﻗﻴﻘﻪ ﺍﺳﺖ‪.‬‬
 ‫ﻓﺎﺯ ﻧﻬﻔﺘﻪ ﺑﺴﺘﺮﻱ‬
‫‪‬ﺍﺭﺯﻳﺎﺑﻲ ﺍﻧﻘﺒﺎﺿﺎﺕ ﺭﺣﻢ‬
‫• ﻫﺮ ‪ 30-60‬ﺩﻗﻴﻘﻪ ﻳﻜﺒﺎﺭ‬
‫‪‬ﺍﺭﺯﻳﺎﺑﻲ ﺻﺪﺍﻱ ﻗﻠﺐ ﺟﻨﻴﻦ‬
‫• ﻫﺮ ‪ 30-60‬ﺩﻗﻴﻘﻪ ﻳﻜﺒﺎﺭ‬
‫• )ﺑﻴﻦ ‪ 110-160‬ﺑﺎﺭ ﺩﺭ ﺩﻗﻴﻘﻪ ﺑﺎ ﺍﻟﮕﻮﻱ ﻃﺒﻴﻌﻲ ﻧﺮﻣﺎﻝ ﻣﺤﺴﻮﺏ‬
‫ﻣﻲ ﺷﻮﺩ(‪.‬‬
 ‫ﻓﺎﺯ ﻧﻬﻔﺘﻪ ﺑﺴﺘﺮﻱ‬
‫‪‬ﺍﺭﺯﻳﺎﺑﻲ ﭘﻴﺸﺮﻓﺖ ﺯﺍﻳﻤﺎﻥ ﻫﺮ ‪ 4‬ﺳﺎﻋﺖ ﻳﻜﺒﺎﺭ‬
‫• ﺑﺎ ﻣﻮﺍﺭﺩ ﺯﻳﺮ ﺍﻣﻜﺎﻥ ﭘﺬﻳﺮ ﺍﺳﺖ‪:‬‬
‫‪ ‬ﺍﻧﺠﺎﻡ ﻣﻌﺎﻳﻨﻪ ﻭﺍژﻳﻨﺎﻝ )ﺗﻐﻴﻴﺮ ﭘﻴﺸﺮﻭﻧﺪﻩ ﺩﺭ ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ﻭ ﺍﻓﺎﺳﻤﺎﻥ‬
‫ﺳﺮﻭﻳﻜﺲ(‬
‫‪ ‬ﺗﺸﺨﻴﺺ ﺗﻐﻴﻴﺮ ﺍﻟﮕﻮﻱ ﺭﻓﺘﺎﺭ ﻣﺎﺩﺭ‬
‫‪ ‬ﺍﻟﮕﻮﻱ ﺍﻧﻘﺒﺎﺿﺎﺕ ﭘﻴﺸﺮﻭﻧﺪﻩ )ﻣﻨﻈﻢ ﺷﺪﻥ ﺍﻧﻘﺒﺎﺿﺎﺕ ﻭ ﺍﻓﺰﺍﻳﺶ‬
‫ﺗﺪﺭﻳﺠﻲ ﺷﺪﺕ ﻭ ﺗﻜﺮﺍﺭ ﺁﻧﻬﺎ(‬
‫‪ ‬ﺗﻐﻴﻴﺮ ﺷﺪﺕ ﻛﻤﺮ ﺩﺭﺩ‬
‫‪ ‬ﺗﻐﻴﻴﺮ ﻣﺤﻞ ﺷﻨﻴﺪﻥ ﺿﺮﺑﺎﻥ ﻗﻠﺐ ﺟﻨﻴﻦ‬
‫‪ ‬ﺍﺣﺴﺎﺱ ﺯﻭﺭ ﺑﺎ ﻣﺎﺩﺭ‬
 ‫ﻓﺎﺯ ﻧﻬﻔﺘﻪ ﺑﺴﺘﺮﻱ‬
‫• ‪ -1‬ﺩﺭ ﺻﻮﺭﺕ ﺍﻧﻘﺒﺎﺿﺎﺕ ﻣﻨﻈﻢ ﺭﺣﻤﻲ ﻭ ﭘﻴﺸﺮﻓﺖ‬
‫ﻧﺎﻣﻨﺎﺳﺐ ﺯﺍﻳﻤﺎﻥ ﻭ‬
‫• ‪ -2‬ﺩﺭ ﺻﻮﺭﺕ ‪:‬‬
‫‪ -‬ﮔﺬﺷﺖ ﺑﻴﺶ ﺍﺯ ‪ 2-6‬ﺳﺎﻋﺖ ﺍﺯ ﭘﺎﺭﮔﻲ ﻛﻴﺴﻪ ﺁﺏ‬
‫ﻭ ﻳﺎ ﻋﺪﻡ ﺷﺮﻭﻉ ﻓﺎﺯ ﻓﻌﺎﻝ ﺑﺎ ﺍﺣﺘﺴﺎﺏ ﺳﺎﻋﺎﺕ ﺗﺤﺖ‬
‫ﻧﻈﺮ)ﺩﺭ ﻣﻮﻟﺘﻲ ﭘﺎﺭﻫﺎ ﺣﺪﺍﻛﺜﺮ ‪ 14‬ﺳﺎﻋﺖ ﻭ ﺩﺭ‬
‫ﭘﺮﺍﻳﻤﻲ ﭘﺎﺭﻫﺎ ﺣﺪﺍﻛﺜﺮ ‪ 20‬ﺳﺎﻋﺖ(‪،‬‬
‫ﺍﻟﻘﺎﻱ ﺯﺍﻳﻤﺎﻥ ﺑﺎﻳﺪ ﺍﻧﺠﺎﻡ ﺷﻮﺩ‪.‬‬
 ‫ﻓﺎﺯ ﻧﻬﻔﺘﻪ ﺑﺴﺘﺮﻱ‬
‫• ﺩﺭ ﺻﻮﺭﺕ ﻣﻨﻈﻢ ﺑﻮﺩﻥ ﺍﻧﻘﺒﺎﺿﺎﺕ ﺭﺣﻤﻲ ﻭ ﭘﻴﺸﺮﻓﺖ‬
‫ﺯﺍﻳﻤﺎﻥ ﺩﺭ ﻣﺎﺩﺭﺍﻥ ﻛﻢ ﺧﻄﺮ‪ ،‬ﺍﺩﺍﻣﻪ ﻣﺮﺍﻗﺒﺖ ﺗﺎ ﺷﺮﻭﻉ‬
‫ﻓﺎﺯ ﻓﻌﺎﻝ ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﺭﻭﺷﻬﺎﻱ ﻛﺎﻫﺶ ﺩﺭﺩ ﺯﺍﻳﻤﺎﻥ‪.‬‬
 ‫ﭘﺮﺩﻩ ﻫﺎﻱ ﺟﻨﻴﻨﻲ ﻭ ﻣﺎﻳﻊ ﺁﻣﻨﻴﻮﺗﻴﻚ‬
‫ﻭﺿﻌﻴﺖ ﮐﻴﺴﻪ ﺁﺏ ﺩﺭ ﻫﺮ ﻣﻌﺎﻳﻨﻪ ﻣﻄﺎﺑﻖ ﻋﻼﺋﻢ ﺯﻳﺮ ﺛﺒﺖ ﻣﯽ ﺷﻮﺩ‪:‬‬
‫)‪ :I( Intact‬ﭘﺮﺩﻩ ﻫﺎ ﺳﺎﻟﻢ ﺍﺳﺖ‪.‬‬ ‫•‬
‫)‪ :R(Rapture‬ﺍﮔﺮ ﻛﻴﺴﻪ ﺁﺏ ﭘﺎﺭﻩ ﺍﺳﺖ‪.‬‬ ‫•‬
‫)‪ :C(Clear‬ﺍﮔﺮ ﻣﺎﻳﻊ ﺁﻣﻨﻴﻮﺗﻴﻚ ﺷﻔﺎﻑ ﺍﺳﺖ‪.‬‬ ‫•‬
‫)‪ :M(Meconium‬ﺩﺭ ﺻﻮﺭﺗﻲ ﻛﻪ ﻣﺎﻳﻊ ﺁﻣﻨﻴﻮﺗﻴﻚ ﺑﻪ ﻣﻜﻮﻧﻴﻮﻡ ﺁﻏﺸﺘﻪ‬ ‫•‬
‫ﺍﺳﺖ‪.‬‬
‫)‪ :B(Bloody‬ﺩﺭ ﺻﻮﺭﺗﻲ ﻛﻪ ﻣﺎﻳﻊ ﺁﻣﻨﻴﻮﺗﻴﻚ ﺑﻪ ﺧﻮﻥ ﺁﻏﺸﺘﻪ ﺍﺳﺖ‪.‬‬ ‫•‬
‫)‪ :A(Absent‬ﺍﮔﺮ ﭘﺮﺩﻩ ﻫﺎﻱ ﺟﻨﻴﻨﻲ ﭘﺎﺭﻩ ﻭ ﻣﺎﻳﻊ ﻭﺟﻮﺩ ﻧﺪﺍﺷﺘﻪ ﺑﺎﺷﺪ‪.‬‬ ‫•‬
‫‪Liquor‬‬
 ‫ﺗﻮﺟﻪ‬
‫• ﺩﺭ ﺻﻮﺭﺗﻲ ﻛﻪ ﻣﺎﻳﻊ ﺁﻣﻨﻴﻮﺗﻴﻚ ﺁﻏﺸﺘﻪ ﺑﻪ ﻣﻜﻮﻧﻴﻮﻡ‬
‫ﻏﻠﻴﻆ ﺑﺎﺷﺪ ﻳﺎ ﺩﺭ ﭘﺮﺩﻩ ﻫﺎﻱ ﺟﻨﻴﻨﻲ ﻣﺎﻳﻊ ﺩﻳﺪﻩ ﻧﺸﻮﺩ‪،‬‬
‫ﺻﺪﺍﻱ ﻗﻠﺐ ﺟﻨﻴﻦ ﺑﺎﻳﺪ ﺩﺭ ﻓﻮﺍﺻﻞ ﻧﺰﺩﻳﻜﺘﺮﻱ ﻛﻨﺘﺮﻝ‬
‫ﮔﺮﺩﺩ‪.‬‬
 ‫ﻣﻮﻟﺪﻳﻨﮓ ﺳﺮﺟﻨﻴﻦ‬
‫• ﻣﻮﻟﺪﻳﻨﮓ ﻋﻼﻣﺖ ﻣﻬﻤﻲ ﺑﺮﺍﻱ ﺗﻄﺎﺑﻖ ﺳﺮ ﺟﻨﻴﻦ ﺑﺎ ﻟﮕﻦ ﺍﺳﺖ‪.‬‬
‫ﺩﺭ ﺻﻮﺭﺗﻲ ﻛﻪ ﺩﺭ ﺍﺳﺘﻴﺸﻦ ﺑﺎﻻ ﻣﻮﻟﺪﻳﻨﮓ ﻭﺟﻮﺩ ﺩﺍﺷﺘﻪ ﺑﺎﺷﺪ‪،‬‬
‫ﻋﻼﻣﺖ ﺷﻮﻣﻲ ﺑﺮﺍﻱ ‪ CPD‬ﺍﺳﺖ‪.‬‬
‫• ﺩﺭﺻﻮﺭﺗﻲ ﻛﻪ ﺁﻣﺎﺱ ﺑﺰﺭﮔﻲ ﻭﺟﻮﺩ ﺩﺍﺷﺘﻪ ﺑﺎﺷﺪ‪ ،‬ﺗﺸﺨﻴﺺ‬
‫ﻣﻮﻟﺪﻳﻨﮓ ﻣﺸﻜﻞ ﺍﺳﺖ ﻛﻪ ﺍﻳﻦ ﻣﺴﺌﻠﻪ ﻳﻚ ﻋﻼﻣﺖ‬
‫ﻫﺸﺪﺍﺭﺩﻫﻨﺪﻩ ﺑﺮﺍﻱ ‪ CPD‬ﺍﺳﺖ‪.‬‬
‫• ﭼﻬﺎﺭ ﺭﻭﺵ ﺛﺒﺖ ﻣﻮﻟﺪﻳﻨﮓ ﺑﺮ ﺭﻭﻱ ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﻭﺟﻮﺩ ﺩﺍﺭﺩ‬
‫ﻛﻪ ﺑﻼﻓﺎﺻﻠﻪ ﺯﻳﺮ ﻗﺴﻤﺖ ﻣﺎﻳﻊ ﺁﻣﻨﻴﻮﺗﻴﻚ ﺛﺒﺖ ﻣﻲ ﮔﺮﺩﺩ‪.‬‬
 ‫ﻧﺤﻮﻩ ﺛﺒﺖ ﻣﻮﻟﺪﻳﻨﮓ‬
‫ﺍﮔﺮ ﺍﺳﺘﺨﻮﺍﻧﻬﺎ ﺍﺯ ﻫﻢ ﺟﺪﺍ ﺑﺎﺷﻨﺪ ﻭ ﺳﭽﻮﺭﻫﺎ ﺑﻪ ﺭﺍﺣﺘﻲ‬ ‫•‬
‫ﺍﺣﺴﺎﺱ ﺷﻮﻧﺪ‪ O :‬ﺛﺒﺖ ﻣﻲ ﺷﻮﺩ‪.‬‬
‫ﺍﮔﺮ ﺍﺳﺘﺨﻮﺍﻧﻬﺎ ﺑﻪ ﻫﻢ ﭼﺴﺒﻴﺪﻩ ﺑﺎﺷﻨﺪ‪ + :‬ﺛﺒﺖ ﻣﻲ ﮔﺮﺩﺩ‪.‬‬ ‫•‬
‫ﺍﮔﺮ ﺍﺳﺘﺨﻮﺍﻧﻬﺎ ﺭﻭﻱ ﻫﻢ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻪ ﺑﺎﺷﻨﺪ‪ ++ :‬ﺛﺒﺖ ﻣﻲ‬ ‫•‬
‫ﮔﺮﺩﺩ‪.‬‬
‫ﺍﮔﺮ ﺍﺳﺘﺨﻮﺍﻧﻬﺎ ﺷﺪﻳﺪﺍً ﺭﻭﻱ ﻫﻢ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻪ ﺑﺎﺷﻨﺪ‪ +++ :‬ﺛﺒﺖ‬ ‫•‬
‫ﻣﻲ ﮔﺮﺩﺩ‪.‬‬
‫‪Molding‬‬ ‫‪O‬‬ ‫‪O‬‬ ‫‪+‬‬
‫ﻭﺿﻌﻴﺖ ﺳﻼﻣﺘﻲ ﺟﻨﻴﻦ‬
‫‪ -2‬ﭘﻴﺸﺮﻓﺖ ﺯﺍﻳﻤﺎﻥ‬
‫‪ ‬ﺍﺗﺴﺎﻉ ﺩﻫﺎﻧﻪ ﺭﺣﻢ‬
‫‪ ‬ﻧﺰﻭﻝ ﺳﺮ ﺟﻨﻴﻦ‬
‫‪ ‬ﺍﻧﻘﺒﺎﺿﺎﺕ ﺭﺣﻢ‬
 ‫ﺍﺗﺴﺎﻉ ﺩﻫﺎﻧﻪ ﺭﺣﻢ‬
‫‪‬ﺑﺎ ﻋﻼﻣﺖ × ﻣﺸﺨﺺ ﻣﻲ ﺷﻮﺩ‪ .‬ﺍﻭﻟﻴﻦ ﻣﻌﺎﻳﻨﻪ ﻭﺍژﻳﻨﺎﻝ ﺩﺭ‬
‫ﺯﻣﺎﻥ ﭘﺬﻳﺮﺵ ﻣﺸﺨﺺ ﺷﺪﻩ ﻭ ﺑﺮ ﺭﻭﻱ ﭘﺎﺭﺗﻮﮔﺮﺍﻑ‬
‫ﺛﺒﺖ ﻣﻲ ﮔﺮﺩﺩ‪ .‬ﻣﻌﺎﻳﻨﺎﺕ ﻭﺍژﻳﻨﺎﻝ ﺑﻌﺪﻱ ﺩﺭ ﻓﻮﺍﺻﻞ ‪4‬‬
‫ﺳﺎﻋﺖ ﻳﻜﺒﺎﺭ ﺗﻜﺮﺍﺭ ﻣﻲ ﮔﺮﺩﺩ ﺍﮔﺮﭼﻪ ﻣﻤﻜﻦ ﺍﺳﺖ ﺑﺎ‬
‫ﭘﻴﺸﺮﻓﺖ ﺯﺍﻳﻤﺎﻥ ﻣﺨﺼﻮﺻﺎً ﺩﺭ ﺧﺎﻧﻤﻬﺎﻱ ﭼﻨﺪﺯﺍ ﺑﻪ‬
‫ﻣﻌﺎﻳﻨﺎﺕ ﺑﻴﺸﺘﺮﻱ ﻧﻴﺎﺯ ﺑﺎﺷﺪ‪.‬‬
‫ﺧﻂ ﺍﺣﺘﻴﺎﻁ )‪ :(Alert‬ﺍﺯ ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ‪ 4‬ﺳﺎﻧﺘﻲ ﻣﺘﺮ ﺷﺮﻭﻉ ﻭ ﺑﻪ‬
‫‪ 10‬ﺳﺎﻧﺘﻲ ﻣﺘﺮ ﺧﺘﻢ ﻣﻲ ﺷﻮﺩ‪ .‬ﻣﺘﻮﺳﻂ ﭘﻴﺸﺮﻓﺖ ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ‪1‬‬
‫ﺳﺎﻧﺘﻲ ﻣﺘﺮ ﺩﺭ ﻳﻚ ﺳﺎﻋﺖ ﺩﺭ ﻧﻈﺮ ﮔﺮﻓﺘﻪ ﺷﺪﻩ ﺍﺳﺖ‪.‬‬
‫ﺧﻂ ﺍﻗﺪﺍﻡ )‪ :(Action‬ﺧﻄﻲ ﻣﻮﺍﺯﻱ ﺧﻂ ﺍﺣﺘﻴﺎﻁ ﺑﻪ ﻓﺎﺻﻠﻪ ‪4‬‬
‫ﺳﺎﻋﺖ ﺍﺯ ﺁﻥ ﻣﻲ ﺑﺎﺷﺪ‪.‬‬
‫ﻣﺪﻝ ﺍﻳﺮﺍﻧﻲ‬
‫ﻣﺪﻝ ﺟﻬﺎﻧﻲ‬
 ‫ﺗﻮﺟﻪ‬
‫‪ ‬ﺗﺎ ﺯﻣﺎﻧﻲ ﻛﻪ ﻋﻼﻣﺖ ﻫﺎ ﺩﺭ ﺳﻤﺖ ﭼﭗ ﺧﻂ ﺍﺣﺘﻴﺎﻁ ﻭ ﻳﺎ ﺭﻭﻱ ﺁﻥ‬
‫ﻗﺮﺍﺭ ﺩﺍﺭﺩ‪ ،‬ﭘﻴﺸﺮﻓﺖ ﺯﺍﻳﻤﺎﻥ ﺭﺿﺎﻳﺖ ﺑﺨﺶ ﺍﺳﺖ‪ .‬ﺯﻣﺎﻧﻲ ﻛﻪ‬
‫ﻣﻨﺤﻨﻲ ﺑﻴﻦ ﺧﻄﻮﻁ ﺍﺣﺘﻴﺎﻁ ﻭ ﺍﻗﺪﺍﻡ ﺑﺎﺷﺪ ﻧﻴﺎﺯ ﺑﻪ ﺑﺮﺭﺳﻲ ﻋﻠﻞ‬
‫ﭘﻴﺸﺮﻓﺖ ﻧﺎﻣﻨﺎﺳﺐ ﺯﺍﻳﻤﺎﻥ ﻭ ﻣﺪﺍﺧﻠﻪ ﻭﺟﻮﺩ ﺩﺍﺭﺩ‪.‬‬
‫‪ ‬ﺩﺭ ﺍﻳﻦ ﻣﺮﺣﻠﻪ ‪ 4‬ﺳﺎﻋﺖ ﺑﻪ ﻣﺎﺩﺭ ﻓﺮﺻﺖ ﺩﺍﺩﻩ ﻭ ﺳﭙﺲ ﭘﻴﺸﺮﻓﺖ‬
‫ﺯﺍﻳﻤﺎﻥ ﺭﺍ ﺑﺮﺭﺳﻲ ﻛﻨﻴﺪ‪ ،‬ﺍﮔﺮ ﻣﻨﺤﻨﻲ ﺍﺯ ﺧﻂ ﺍﻗﺪﺍﻡ ﺑﮕﺬﺭﺩ ﺑﺎﻳﺪ‬
‫ﺗﺼﻤﻴﻢ ﮔﻴﺮﻱ ﺳﺮﻳﻊ ﺑﺮﺍﻱ ﺧﺘﻢ ﺑﺎﺭﺩﺍﺭﻱ ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﺷﺮﺍﻳﻂ ﻣﺎﺩﺭ‬
‫ﻭ ﺟﻨﻴﻦ ﺍﻧﺠﺎﻡ ﺷﻮﺩ‪.‬‬
‫‪ ‬ﺯﻣﺎﻧﻴﻜﻪ ﭘﺬﻳﺮﺵ ﺩﺭ ﻓﺎﺯ ﻧﻬﻔﺘﻪ ﺍﻧﺠﺎﻡ ﻣﻲ ﺷﻮﺩ‪ ،‬ﺩﻳﻼﺗﺎﺳﻴﻮﻥ‬
‫ﺳﺮﻭﻳﻜﺲ ﺩﺭ ﺯﻣﺎﻥ ﺻﻔﺮ )ﺍﻭﻟﻴﻦ ﺧﺎﻧﻪ( ﺭﺳﻢ ﺷﺪﻩ ﻭ ﻣﻌﺎﻳﻨﻪ‬
‫ﻭﺍژﻳﻨﺎﻝ ﻫﺮ ‪ 4‬ﺳﺎﻋﺖ ﺍﻧﺠﺎﻡ ﻣﻲ ﺷﻮﺩ‪.‬‬
 ‫ﻣﺜﺎﻝ‬
‫ﭘﺬﻳﺮﺵ ﺩﺭ ﺳﺎﻋﺖ ‪ 9‬ﺻﺒﺢ ﻭ ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ‪ 1‬ﺳﺎﻧﺖ‬ ‫•‬
‫ﺩﺭ ﺳﺎﻋﺖ ‪ 13‬ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ‪ 2‬ﺳﺎﻧﺖ‬ ‫•‬
‫ﺩﺭ ﺳﺎﻋﺖ ‪ 17‬ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ‪ 3‬ﺳﺎﻧﺖ )ﻓﺎﺯ ﻓﻌﺎﻝ(‬ ‫•‬
‫ﺩﺭ ﺳﺎﻋﺖ ‪ 20‬ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ‪ 10‬ﺳﺎﻧﺖ‬ ‫•‬
‫ﻓﺎﺯ ﻧﻬﻔﺘﻪ ‪ 8‬ﺳﺎﻋﺖ ﻭ ﻓﺎﺯ ﻓﻌﺎﻝ ‪ 3‬ﺳﺎﻋﺖ ﻃﻮﻝ ﻛﺸﻴﺪﻩ ﺍﺳﺖ‪.‬‬ ‫•‬
 ‫ﻣﺜﺎﻝ‬
‫• ﻧﻤﻮﺩﺍﺭ ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﺭﺍ ﺑﺮﺍﻱ ﻣﻮﺭﺩ ﺯﻳﺮ ﺛﺒﺖ ﻛﻨﻴﺪ‪.‬‬
‫‪ -‬ﺯﻣﺎﻥ ﭘﺬﻳﺮﺵ ﺳﺎﻋﺖ ‪15‬‬
‫‪ -‬ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ﺳﺮﻭﻳﻜﺲ‪ 4 :‬ﺳﺎﻧﺖ‬
‫‪ -‬ﺩﺭ ﺳﺎﻋﺖ ‪ 17‬ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ‪ 10‬ﺳﺎﻧﺖ‬
 ‫ﻧﻜﺘﻪ‬
‫• ﺯﻣﺎﻧﻴﻜﻪ ﺍﺗﺴﺎﻉ ﺩﻫﺎﻧﻪ ﺭﺣﻢ ‪ 0-2‬ﺳﺎﻧﺖ ﺍﺳﺖ ﻧﻤﻮﺩﺍﺭ‬
‫ﺩﺭ ﻗﺴﻤﺖ ﻓﺎﺯ ﻧﻬﻔﺘﻪ ﺭﺳﻢ ﻣﻲ ﮔﺮﺩﺩ ﻭ ﺯﻣﺎﻧﻴﻜﻪ ﻭﺍﺭﺩ‬
‫ﻓﺎﺯ ﻓﻌﺎﻝ ﻣﻲ ﺷﻮﺩ‪ ،‬ﻧﻤﻮﺩﺍﺭ ﺑﺎﻳﺪ ﺗﻮﺳﻂ ﻳﻚ ﺧﻂ‬
‫ﺷﻜﺴﺘﻪ ﺑﻪ ﺧﻂ ﺍﺧﻄﺎﺭ ﻣﻨﺘﻘﻞ ﺷﺪﻩ ﻭ ﺳﭙﺲ ﻳﺎﻓﺘﻪ ﻫﺎﻱ‬
‫ﻣﺮﺑﻮﻁ ﺑﻪ ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ﻭ ﺯﻣﺎﻥ ﻣﻌﺎﻳﻨﻪ ﺛﺒﺖ ﮔﺮﺩﺩ‪.‬‬
 ‫ﻣﺜﺎﻝ‬
‫• ﺯﻣﺎﻥ ﭘﺬﻳﺮﺵ ﺳﺎﻋﺖ ‪ 14‬ﺩﺭ ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ‪ 2‬ﺳﺎﻧﺖ‬
‫• ﺩﺭ ﺳﺎﻋﺖ ‪ 18‬ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ‪ 6‬ﺳﺎﻧﺖ‬
‫• ﺩﺭ ﺳﺎﻋﺖ ‪ 22‬ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ‪ 10‬ﺳﺎﻧﺖ‬
 ‫ﻳﺎﺩﺁﻭﺭﻱ‬
‫ﻓﺎﺯ ﻧﻬﻔﺘﻪ ﺑﻪ ﻃﻮﺭ ﻣﺘﻮﺳﻂ ﻧﺒﺎﻳﺪ ﺑﻴﺸﺘﺮ ﺍﺯ ‪ 8‬ﺳﺎﻋﺖ ﻃﻮﻝ ﺑﻜﺸﺪ‪.‬‬ ‫•‬
‫ﺣﺪﺍﻗﻞ ﭘﻴﺸﺮﻓﺖ ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ﺩﺭ ﻓﺎﺯ ﻓﻌﺎﻝ‪ 1 ،‬ﺳﺎﻧﺖ ﺩﺭ ﺳﺎﻋﺖ‬ ‫•‬
‫ﺍﺳﺖ‪.‬‬
‫ﺯﻣﺎﻧﻴﻜﻪ ﭘﺬﻳﺮﺵ ﺩﺭ ﻓﺎﺯ ﻓﻌﺎﻝ ﺍﺳﺖ‪ ،‬ﻧﻤﻮﺩﺍﺭ ﺍﺗﺴﺎﻉ ﺩﻫﺎﻧﻪ ﺭﺣﻢ‬ ‫•‬
‫ﺑﺎﻳﺪ ﺑﻼﻓﺎﺻﻠﻪ ﺑﺮ ﺭﻭﻱ ﺧﻂ ﺍﺧﻄﺎﺭ ﺩﻫﻨﺪﻩ ﺭﺳﻢ ﺷﻮﺩ‪.‬‬
‫ﺯﻣﺎﻧﻴﻜﻪ ﭘﻴﺸﺮﻓﺖ ﺯﺍﻳﻤﺎﻥ ﻣﻨﺎﺳﺐ ﺍﺳﺖ‪ ،‬ﻧﻤﻮﺩﺍﺭ ﺍﺗﺴﺎﻉ ﻧﺒﺎﻳﺪ ﺑﻪ‬ ‫•‬
‫ﺳﻤﺖ ﺭﺍﺳﺖ ﺧﻂ ﻓﻌﺎﻝ ﻛﺸﻴﺪﻩ ﺷﻮﺩ‪.‬‬
 ‫ﻧﺰﻭﻝ ﺳﺮ ﺟﻨﻴﻦ‬
‫• ﻣﻨﺤﻨﻲ ﻧﺰﻭﻝ ﺳﺮ ﺟﻨﻴﻦ ﺩﺭ ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ‪ WHO‬ﺑﺮ ﺭﻭﻱ‬
‫ﻧﻤﻮﺩﺍﺭ ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ﻛﺸﻴﺪﻩ ﻣﻲ ﺷﻮﺩ‪.‬‬
‫• ﻧﺰﻭﻝ ﺳﺮ ﺑﺎ ﻣﻌﺎﻳﻨﻪ ﺷﻜﻤﻲ ﺗﻌﻴﻴﻦ ﻣﻲ ﺷﻮﺩ ﻭ ﺍﺯ ﻣﻌﻴﺎﺭ ‪ 0/5‬ﺗﺎ‬
‫‪ 5/5‬ﺍﺳﺘﻔﺎﺩﻩ ﻣﻲ ﺷﻮﺩ‪.‬‬
‫• ﺍﺯ ﺁﻧﺠﺎﻳﻲ ﻛﻪ ﺩﺭ ﻛﺸﻮﺭ ﻣﺎ ﺗﻌﻴﻴﻦ ﻧﺰﻭﻝ ﺳﺮ ﺑﺎ ﻣﻌﺎﻳﻨﻪ ﻭﺍژﻳﻨﺎﻝ‬
‫ﻭ ﺑﺮ ﺍﺳﺎﺱ ﻓﺎﺻﻠﻪ ﺳﺮ ﺟﻨﻴﻦ ﺗﺎ ﺧﺎﺭ ﺍﻳﺴﻜﻴﺎﻝ ﺳﻨﺠﻴﺪﻩ ﻣﻲ‬
‫ﺷﻮﺩ‪ ،‬ﺟﺪﻭﻟﻲ ﻣﻄﺎﺑﻖ ﺑﺎ ﻣﻌﻴﺎﺭ ‪ -3‬ﺗﺎ ‪ +3‬ﺩﺭ ﺯﻳﺮِ ﺟﺪﻭﻝ‬
‫ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ﻃﺮﺍﺣﻲ ﺷﺪﻩ ﺗﺎ ﻧﺰﻭﻝ ﺳﺮ ﺟﻨﻴﻦ ﺩﺭ ﺁﻥ ﺛﺒﺖ‬
‫ﺷﻮﺩ‪.‬‬
‫ﻣﺪﻝ ﺟﻬﺎﻧﻲ‬
‫ﻣﺪﻝ ﺍﻳﺮﺍﻧﻲ‬
 ‫ﺗﻌﻴﻴﻦ ﻧﺰﻭﻝ ﺳﺮ ﺟﻨﻴﻦ‬
‫• ﺗﻌﻴﻴﻦ ﻣﻴﺰﺍﻥ ﻧﺰﻭﻝ ﺳﺮ ﺟﻨﻴﻦ ﻫﻤﻴﺸﻪ ﺑﺎﻳﺪ ﻗﺒﻞ ﺍﺯ ﻣﻌﺎﻳﻨﻪ‬
‫ﻭﺍژﻳﻨﺎﻝ ﺍﻧﺠﺎﻡ ﺷﻮﺩ‪.‬‬
‫• ﻧﺰﻭﻝ ﺑﺎ ﻋﻼﻣﺖ ‪ O‬ﻣﺸﺨﺺ ﻣﻲ ﮔﺮﺩﺩ‪.‬‬
‫• ﻣﻴﺰﺍﻥ ﻧﺰﻭﻝ ﺍﺯ ‪ 2‬ﺭﺍﻩ ﺗﺸﺨﻴﺺ ﺩﺍﺩﻩ ﻣﻲ ﺷﻮﺩ‪:‬‬
‫‪ ‬ﺑﺎ ﻣﻌﺎﻳﻨﻪ ﺷﮑﻤﯽ‬
‫‪ ‬ﺑﺎ ﻣﻌﺎﻳﻨﻪ ﻭﺍژﻳﻨﺎﻝ‬
‫ﺗﻌﻴﻴﻦ ﻧﺰﻭﻝ ﺳﺮ ﺟﻨﻴﻦ ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﻣﻌﺎﻳﻨﻪ ﺷﻜﻤﻲ‬
 ‫ﻣﺜﺎﻝ‬
‫ﺩﺭ ﻫﻨﮕﺎﻡ ﭘﺬﻳﺮﺵ )ﺳﺎﻋﺖ ‪ 5/5 (13‬ﺳﺮ ﺑﺎﻻﻱ ﺗﻨﮕﻪ ﺩﺧﻮﻝ‬ ‫•‬
‫ﻗﺮﺍﺭ ﺩﺍﺷﺘﻪ ﻭ ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ﺳﺮﻭﻳﻜﺲ ‪ 1‬ﺳﺎﻧﺖ ﺍﺳﺖ‪.‬‬
‫ﺩﺭ ﺳﺎﻋﺖ ‪ 4/5 ،17‬ﺳﺮ ﺑﺎﻻﻱ ﺗﻨﮕﻪ ﺩﺧﻮﻝ ﻗﺮﺍﺭ ﺩﺍﺷﺘﻪ ﻭ‬ ‫•‬
‫ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ﺳﺮﻭﻳﻜﺲ ‪ 5‬ﺳﺎﻧﺖ ﺍﺳﺖ‪.‬‬
‫ﭘﺲ ﺍﺯ ‪ 3‬ﺳﺎﻋﺖ ‪ 1/5‬ﺳﺮ ﺑﺎﻻﻱ ﺗﻨﮕﻪ ﺩﺧﻮﻝ ﻗﺮﺍﺭ ﺩﺍﺷﺘﻪ ﻭ‬ ‫•‬
‫ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ﺳﺮﻭﻳﻜﺲ ‪ 10‬ﺳﺎﻧﺖ ﺍﺳﺖ‪.‬‬
‫ﻃﻮﻝ ﻣﺮﺣﻠﻪ ﺍﻭﻝ ﺯﺍﻳﻤﺎﻥ ﺍﺯ ﺯﻣﺎﻥ ﭘﺬﻳﺮﺵ ‪ 7‬ﺳﺎﻋﺖ ﺍﺳﺖ‪.‬‬ ‫•‬
 ‫ﺍﻧﻘﺒﺎﺿﺎﺕ ﺭﺣﻢ‬
‫• ﺩﺭ ﻳﻚ ﺯﺍﻳﻤﺎﻥ ﻃﺒﻴﻌﻲ ﺑﺎ ﭘﻴﺸﺮﻓﺖ ﺯﺍﻳﻤﺎﻥ‪ ،‬ﻣﺪﺕ ﻭ ﺗﻌﺪﺍﺩ‬
‫ﺍﻧﻘﺒﺎﺿﺎﺕ ﺭﺣﻢ ﺍﻓﺰﺍﻳﺶ ﻣﻲ ﻳﺎﺑﺪ‪.‬‬
‫• ﺍﻧﻘﺎﺿﺎﺕ ﺭﺣﻢ ﺩﺭ ﻓﺎﺯ ﻧﻬﻔﺘﻪ ﻫﺮ ‪ 30‬ﺗﺎ ‪ 60‬ﺩﻗﻴﻘﻪ ﻳﻜﺒﺎﺭ ﻭ ﺩﺭ‬
‫ﻓﺎﺯ ﻓﻌﺎﻝ ﻫﺮ ‪ 30‬ﺩﻗﻴﻘﻪ ﻳﻜﺒﺎﺭ ﻛﻨﺘﺮﻝ ﻣﻲ ﮔﺮﺩﺩ‪.‬‬
‫• ﺍﻧﻘﺒﺎﺿﺎﺕ ﺭﺣﻢ ﺭﺍ ﺩﺭ ‪ 10‬ﺩﻗﻴﻘﻪ ﻛﻨﺘﺮﻝ ﻛﻨﻴﺪ‪.‬‬
 ‫ﺩﺭ ﻣﺪﻝ ﺍﻳﺮﺍﻧﻲ‬
‫• ﺑﻪ ﻣﻨﻈﻮﺭﺛﺒﺖ ﺍﻧﻘﺒﺎﺿﺎﺕ‪ ،‬ﻣﺪﺕ ﻭ ﺗﻌﺪﺍﺩ ﺍﻧﻘﺒﺎﺿﺎﺕ ﺩﺭ ﺩﻩ‬
‫ﺩﻗﻴﻘﻪ ﻧﻮﺷﺘﻪ ﻣﻲ ﺷﻮﺩ‪:‬‬
‫• ﻣﺜﻼ" ﭼﻨﺎﻧﭽﻪ ﻣﺎﺩﺭ ﺳﻪ ﺍﻧﻘﺒﺎﺽ ﺩﺭ ﺩﻩ ﺩﻗﻴﻘﻪ ﺩﺍﺭﺩ ﻭ ﻫﺮ‬
‫ﺍﻧﻘﺒﺎﺽ ‪ 40‬ﺛﺎﻧﻴﻪ ﻃﻮﻝ ﻣﻲ ﻛﺸﺪ ﺑﻪ ﺍﻳﻦ ﺻﻮﺭﺕ ﻧﻮﺷﺘﻪ‬
‫ﻣﻲ ﺷﻮﺩ‪3 ×40 :‬‬

‫‪٣‬‬
‫×‬
‫‪۴٠‬‬
 ‫ﺩﺭ ﻣﺪﻝ ﺟﻬﺎﻧﻲ‬
‫• ﺩﺭ ﻧﻤﻮﺩﺍﺭﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﺩﺭ ﺯﻳﺮ ﺧﻂ ﻣﺮﺑﻮﻁ ﺑﻪ ﺯﻣﺎﻥ‪ 5 ،‬ﺧﺎﻧﻪ‬
‫ﻭﺟﻮﺩ ﺩﺍﺭﺩ ﻛﻪ ﻧﺸﺎﻧﮕﺮ ﺗﻌﺪﺍﺩ ﻛﻨﺘﺮﺍﻛﺸﻨﻬﺎ ﺩﺭ ‪ 10‬ﺩﻗﻴﻘﻪ ﻣﻲ‬
‫ﺑﺎﺷﺪ‪.‬‬
‫• ﻫﺮ ﺧﺎﻧﻪ ﻧﻤﺎﻳﺎﻧﮕﺮ ﻳﻚ ﺍﻧﻘﺒﺎﺽ ﺑﻮﺩﻩ ﻛﻪ ﺑﺎ ﺳﺎﻳﻪ ﺯﺩﻥ ﺁﻥ‬
‫ﻣﺸﺨﺺ ﻣﻲ ﮔﺮﺩﺩ‪.‬‬
‫ﺩﺭ ﻣﺪﻝ ﺟﻬﺎﻧﻲ‬
‫• ‪ 5‬ﺭﺩﻳﻒ ﺧﺎﻧﻪ ﺑﺮﺍﻱ ﺗﻌﻴﻴﻦ ﺗﻌﺪﺍﺩ‬
‫ﺍﻧﻘﺒﺎﺽ ﺩﺭ ‪ 10‬ﺩﻗﻴﻘﻪ ﻭﺟﻮﺩ‬
‫ﺩﺍﺭﺩﻛﻪ ﺑﺎﻳﺪ ﺑﻪ ﺍﺯﺍﻱ ﻫﺮ ﺍﻧﻘﺒﺎﺽ‬
‫ﻳﻚ ﺧﺎﻧﻪ ﭘﺮ ﺷﻮﺩ‪ .‬ﺑﺴﺘﻪ ﺑﻪ ﺍﻳﻨﻜﻪ‬
‫ﻣﺪﺕ ﺍﻧﻘﺒﺎﺽ ﺧﺎﻧﻪ ﻫﺎ ﻃﺒﻖ ﺭﺍﻫﻨﻤﺎ‬
‫ﭘﺮ ﻣﻲ ﺷﻮﺩ‪.‬‬
 ‫ﻣﺜﺎﻝ‬
‫ﻧﻴﻢ ﺳﺎﻋﺖ ﺍﻭﻝ ﻭ ﺩﻭﻡ‪ :‬ﺩﺭ ‪ 10‬ﺩﻗﻴﻘﻪ ﺁﺧﺮ ‪ 2‬ﺍﻧﻘﺒﺎﺽ ﻭﺟﻮﺩ ﺩﺍﺭﺩ‬ ‫•‬
‫ﻛﻪ ﻫﺮ ﻛﺪﺍﻡ ﻛﻤﺘﺮ ﺍﺯ ‪ 20‬ﺛﺎﻧﻴﻪ ﻃﻮﻝ ﻛﺸﻴﺪﻩ ﺍﺳﺖ‪.‬‬
‫ﻧﻴﻢ ﺳﺎﻋﺖ ﺳﻮﻡ ﻭﭼﻬﺎﺭﻡ‪ :‬ﺩﺭ ‪ 10‬ﺩﻗﻴﻘﻪ ﺁﺧﺮ ‪ 3‬ﺍﻧﻘﺒﺎﺽ ﻭﺟﻮﺩ‬ ‫•‬
‫ﺩﺍﺭﺩ ﻛﻪ ﻫﺮ ﻛﺪﺍﻡ ﻛﻤﺘﺮ ﺍﺯ ‪ 20‬ﺛﺎﻧﻴﻪ ﻃﻮﻝ ﻛﺸﻴﺪﻩ ﺍﺳﺖ‪.‬‬
‫ﻧﻴﻢ ﺳﺎﻋﺖ ﭘﻨﺠﻢ‪ :‬ﺩﺭ ‪ 10‬ﺩﻗﻴﻘﻪ ﺁﺧﺮ ‪ 3‬ﺍﻧﻘﺒﺎﺽ ﻭﺟﻮﺩ ﺩﺍﺭﺩ ﻛﻪ‬ ‫•‬
‫ﻫﺮ ﻛﺪﺍﻡ ﺑﻴﻦ‪ 20-40‬ﺛﺎﻧﻴﻪ ﻃﻮﻝ ﻛﺸﻴﺪﻩ ﺍﺳﺖ‪.‬‬
‫ﻧﻴﻢ ﺳﺎﻋﺖ ﺷﺸﻢ‪ :‬ﺩﺭ ‪ 10‬ﺩﻗﻴﻘﻪ ﺁﺧﺮ ‪ 4‬ﺍﻧﻘﺒﺎﺽ ﻭﺟﻮﺩ ﺩﺍﺭﺩ ﻛﻪ‬ ‫•‬
‫ﻫﺮ ﻛﺪﺍﻡ ﺑﻴﻦ‪ 20-40‬ﺛﺎﻧﻴﻪ ﻃﻮﻝ ﻛﺸﻴﺪﻩ ﺍﺳﺖ‪.‬‬
‫ﻧﻴﻢ ﺳﺎﻋﺖ ﻫﻔﺘﻢ‪ :‬ﺩﺭ ‪ 10‬ﺩﻗﻴﻘﻪ ﺁﺧﺮ ‪ 5‬ﺍﻧﻘﺒﺎﺽ ﻭﺟﻮﺩ ﺩﺍﺭﺩ ﻛﻪ‬ ‫•‬
‫ﻫﺮ ﻛﺪﺍﻡ ﺑﻴﺸﺘﺮ ﺍﺯ ‪ 40‬ﺛﺎﻧﻴﻪ ﻃﻮﻝ ﻛﺸﻴﺪﻩ ﺍﺳﺖ‪.‬‬
 ‫ﻣﺜﺎﻝ‬
‫ﭘﺬﻳﺮﺵ ﺩﺭ ﺳﺎﻋﺖ ‪ 14‬ﻓﺎﺯ ﻓﻌﺎﻝ ﺍﺳﺖ‪ .‬ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ‪ 3‬ﺳﺎﻧﺖ ﻭ‬ ‫•‬
‫‪ 4/5‬ﺳﺮ ﺩﺭ ﺑﺎﻻﻱ ﺗﻨﮕﻪ ﺩﺧﻮﻝ ﻗﺮﺍﺭ ﺩﺍﺭﺩ‪.‬‬
‫ﺍﻧﻘﺒﺎﺿﺎﺕ‪ :‬ﺩﺭ ﺍﺑﺘﺪﺍ ‪ 1‬ﺍﻧﻘﺒﺎﺽ ﻃﻲ ‪ 10‬ﺩﻗﻴﻘﻪ ﻛﻪ ‪ 20-40‬ﺛﺎﻧﻴﻪ‬ ‫•‬
‫ﻃﻮﻝ ﻛﺸﻴﺪﻩ ﺍﺳﺖ‪.‬‬
‫ﺩﺭ ﺳﺎﻋﺖ ‪ 18‬ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ‪ 7‬ﺳﺎﻧﺖ ﻭ ‪ 3/5‬ﺳﺮ ﺩﺭ ﺑﺎﻻﻱ ﺗﻨﮕﻪ‬ ‫•‬
‫ﺩﺧﻮﻝ ﻗﺮﺍﺭ ﺩﺍﺷﺘﻪ ﻭ ‪ 4‬ﺍﻧﻘﺒﺎﺽ ﻃﻲ ‪ 10‬ﺩﻗﻴﻘﻪ ﻛﻪ ‪ 20-40‬ﺛﺎﻧﻴﻪ‬
‫ﻃﻮﻝ ﻛﺸﻴﺪﻩ ﺍﺳﺖ‪.‬‬
‫ﺩﺭ ﺳﺎﻋﺖ ‪ 21‬ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ‪ 10‬ﺳﺎﻧﺖ ﻭ ‪ 0/5‬ﺳﺮ ﺩﺭ ﺑﺎﻻﻱ ﺗﻨﮕﻪ‬ ‫•‬
‫ﺩﺧﻮﻝ ﻗﺮﺍﺭ ﺩﺍﺷﺘﻪ ﻭ ‪ 5‬ﺍﻧﻘﺒﺎﺽ ﻃﻲ ‪ 10‬ﺩﻗﻴﻘﻪ ﻛﻪ ﻫﺮ ﻛﺪﺍﻡ‬
‫ﺑﻴﺸﺘﺮ ﺍﺯ ‪ 40‬ﺛﺎﻧﻴﻪ ﻃﻮﻝ ﻛﺸﻴﺪﻩ ﺍﺳﺖ‪.‬‬
 ‫‪ -3‬ﻭﺿﻌﻴﺖ ﻣﺎﺩﺭ‬
‫• ﺩﺭ ﺍﻧﺘﻬﺎی ﭘﺎﺭﺗﻮﮔﺮﺍﻑ ﻭ ﺯﻳﺮ ﻣﺤﻞ ﺛﺒﺖ ﺍﻧﻘﺒﺎﺿﺎﺕ ﺭﺣﻢ ﻗﺮﺍﺭ‬
‫ﺩﺍﺷﺘﻪ ﻭ ﺷﺎﻣﻞ‪:‬‬
‫‪ -1‬ﺍﻛﺴﻲ ﺗﻮﺳﻴﻦ‬
‫‪ -2‬ﺩﺍﺭﻭﻫﺎ ﻭ ﻣﺎﻳﻌﺎﺕ ﻭﺭﻳﺪﻱ‬
‫‪ -3‬ﻋﻼﺋﻢ ﺣﻴﺎﺗﻲ )ﻧﺒﺾ‪ ،‬ﻓﺸﺎﺭﺧﻮﻥ ﻭ ﺩﺭﺟﻪ ﺣﺮﺍﺭﺕ(‬
‫‪ -4‬ﺍﺩﺭﺍﺭ)ﺣﺠﻢ‪ ،‬ﭘﺮﻭﺗﺌﻴﻦ ﻭ ﺍﺳﺘﻮﻥ(‬
‫ﺍﻛﺴﻲ ﺗﻮﺳﻴﻦ‬
‫ﺩﺍﺭﻭﻫﺎ ﻭ ﻣﺎﻳﻌﺎﺕ ﻭﺭﻳﺪﻱ‬
‫ﻋﻼﺋﻢ ﺣﻴﺎﺗﻲ‬
‫ﺍﺩﺭﺍﺭ‬
‫ﻭﺿﻌﻴﺖ ﻣﺎﺩﺭ‬
 ‫ﭘﻴﺸﺮﻓﺖ ﻏﻴﺮ ﻃﺒﻴﻌﻲ ﺯﺍﻳﻤﺎﻥ‬
‫• ﺩﺭ ﺻﻮﺭﺗﻲ ﻛﻪ ﺧﺎﻧﻢ ﺩﺭ ﻓﺎﺯ ﻧﻬﻔﺘﻪ ﺑﺴﺘﺮﻱ ﺷﺪﻩ ﻭ ﺑﻪ ﻣﺪﺕ ‪8‬‬
‫ﺳﺎﻋﺖ ﺩﺭ ﺍﻳﻦ ﻓﺎﺯ ﺑﺎﻗﻲ ﺑﻤﺎﻧﺪ‪ ،‬ﭘﻴﺸﺮﻓﺖ ﺯﺍﻳﻤﺎﻥ ﻏﻴﺮ ﻃﺒﻴﻌﻲ‬
‫ﺗﻠﻘﻲ ﺷﺪﻩ ﻭ ﺑﺎﻳﺪ ﺍﻗﺪﺍﻣﺎﺕ ﻻﺯﻡ ﺑﻪ ﻋﻤﻞ ﺁﻣﺪﻩ ﻭ ﻳﺎ ﺑﻪ‬
‫ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﻣﻨﺘﻘﻞ ﺷﻮﺩ‪.‬‬
‫ﻧﻤﻮﺩﺍﺭ ﺯﻳﺮ ﺭﺍ ﺗﻔﺴﻴﺮ ﻛﻨﻴﺪ‬
 ‫ﺗﻔﺴﻴﺮ‬
‫• ﺩﺭ ﻫﻨﮕﺎﻡ ﭘﺬﻳﺮﺵ ﺩﺭ ﺳﺎﻋﺖ ‪ 7‬ﻧﺰﻭﻝ ﺳﺮ ﺟﻨﻴﻦ ‪ 5/5‬ﻭ‬
‫ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ﺳﺮﻭﻳﻜﺲ ‪ 1‬ﺳﺎﻧﺖ ﺍﺳﺖ‪ .‬ﺩﻭ ﺍﻧﻘﺒﺎﺽ ﺩﺭ ﺩﻗﻴﻘﻪ‬
‫ﻭﺟﻮﺩ ﺩﺍﺭﺩ ﻛﻪ ﻫﺮ ﻛﺪﺍﻡ ‪ 20-40‬ﺛﺎﻧﻴﻪ ﻃﻮﻝ ﻣﻲ ﻛﺸﺪ‪.‬‬
‫• ﭘﺲ ﺍﺯ ‪ 4‬ﺳﺎﻋﺖ ﺩﺭ ﺳﺎﻋﺖ ‪ 11‬ﻧﺰﻭﻝ ﺳﺮ ﺟﻨﻴﻦ ‪ 4/5‬ﻭ‬
‫ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ﺳﺮﻭﻳﻜﺲ ‪ 2‬ﺳﺎﻧﺖ ﺍﺳﺖ‪ .‬ﺩﻭ ﺍﻧﻘﺒﺎﺽ ﺩﺭ ﺩﻗﻴﻘﻪ‬
‫ﻭﺟﻮﺩ ﺩﺍﺭﺩ ﻛﻪ ﻫﺮ ﻛﺪﺍﻡ ‪ 20-40‬ﺛﺎﻧﻴﻪ ﻃﻮﻝ ﻣﻲ ﻛﺸﺪ‪.‬‬
‫• ﻃﻮﻝ ﻓﺎﺯ ﻧﻬﻔﺘﻪ ﺍﺯ ﺯﻣﺎﻥ ﭘﺬﻳﺮﺵ ‪ 8‬ﺳﺎﻋﺖ ﺍﺳﺖ‪.‬‬
 ‫ﻓﺎﺯ ﻓﻌﺎﻝ ﻃﻮﻻﻧﻲ‬
‫• ﺣﺮﮐﺖ ﺑﻪ ﺳﻤﺖ ﺧﻂ ﺍﺧﻄﺎﺭ ﺩﻫﻨﺪﻩ‪:‬‬
‫ﺑﻪ ﻃﻮﺭ ﻃﺒﻴﻌﻲ ﻧﻤﻮﺩﺍﺭﺩﺭ ﻓﺎﺯ ﻓﻌﺎﻝ ﺑﺮ ﺭﻭﻱ ﺧﻂ ﺍﺧﻄﺎﺭ ﻳﺎ ﺳﻤﺖ‬
‫ﭼﭗ ﺁﻥ ﻗﺮﺍﺭ ﻣﻲ ﮔﻴﺮﺩ‪ .‬ﺍﻣﺎ ﺯﻣﺎﻧﻲ ﻛﻪ ﺑﻪ ﺳﻤﺖ ﺭﺍﺳﺖ ﺧﻂ‬
‫ﺍﺧﻄﺎﺭ ﻛﺸﻴﺪﻩ ﺷﻮﺩ ﻭ ﺗﺠﻬﻴﺰﺍﺕ ﻛﺎﻓﻲ ﺩﺭ ﻣﺤﻞ ﻧﺒﺎﺷﺪ‪ ،‬ﻣﺎﺩﺭ ﺑﺎﻳﺪ‬
‫ﺑﻪ ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﻣﻨﺘﻘﻞ ﺷﺪﻩ ﺗﺎ ﺍﻗﺪﺍﻡ ﻣﻨﺎﺳﺐ ﺍﻧﺠﺎﻡ ﺷﻮﺩ ﻣﮕﺮ‬
‫ﺍﻳﻨﻜﻪ ﺯﻣﺎﻥ ﺯﺍﻳﻤﺎﻥ ﻧﺰﺩﻳﻚ ﺑﺎﺷﺪ‪.‬‬
 ‫ﻓﺎﺯ ﻓﻌﺎﻝ ﻃﻮﻻﻧﻲ‬
‫• ﺩﺭ ﺧﻂ ﻓﻌﺎﻝ‪:‬‬
‫ﺧﻂ ﻓﻌﺎﻝ ﺩﺭ ﻣﺤﻞ ‪ 4‬ﺳﺎﻋﺖ ﭘﺲ ﺍﺯ ﺧﻂ ﺍﺧﻄﺎﺭﺩﻫﻨﺪﻩ ﻗﺮﺍﺭ‬
‫ﺩﺍﺭﺩ‪ .‬ﺩﺭ ﺻﻮﺭﺗﻲ ﻛﻪ ﻧﻤﻮﺩﺍﺭ ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ﺑﻪ ﺍﻳﻦ ﺧﻂ ﺑﺮﺳﺪ‪ ،‬ﺑﺎﻳﺪ‬
‫ﻋﻠﺖ ﻛﻨﺪ ﭘﻴﺸﺮﻓﺖ ﺯﺍﻳﻤﺎﻥ ﻣﺸﺨﺺ ﺷﺪﻩ ﻭ ﺍﻗﺪﺍﻡ ﻣﻨﺎﺳﺐ ﺍﻧﺠﺎﻡ‬
‫ﮔﻴﺮﺩ‪.‬‬
‫ﻧﻤﻮﺩﺍﺭ ﺯﻳﺮ ﺭﺍ ﺗﻔﺴﻴﺮ ﻛﻨﻴﺪ‬
 ‫ﺗﻔﺴﻴﺮ‬
‫• ﺩﺭ ﺳﺎﻋﺖ ‪ ،8‬ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ﺳﺮﻭﻳﻜﺲ ‪ 3‬ﺳﺎﻧﺖ ﺍﺳﺖ‪ .‬ﻣﺎﺩﺭ‬
‫ﻣﻤﻜﻨﺴﺖ ﺩﺭ ﻣﺮﺍﻛﺰ ﺑﻬﺪﺍﺷﺘﻲ ﺑﻤﺎﻧﺪ‪.‬‬
‫• ﺩﺭ ﺳﺎﻋﺖ ‪ ،12‬ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ﺳﺮﻭﻳﻜﺲ ‪ 6‬ﺳﺎﻧﺖ ﺍﺳﺖ ﻭ‬
‫ﻧﻤﻮﺩﺍﺭ ﺑﻪ ﺳﻤﺖ ﺭﺍﺳﺖ ﺧﻂ ﺍﺧﻄﺎﺭﺩﻫﻨﺪﻩ ﻛﺸﻴﺪﻩ ﺷﺪﻩ ﺍﺳﺖ‪.‬‬
‫ﻣﺎﺩﺭ ﺑﺎﻳﺪ ﺑﻪ ﻳﻚ ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﺑﺎ ﺗﺠﻬﻴﺰﺍﺕ ﻛﺎﻓﻲ ﻣﻨﺘﻘﻞ ﺷﻮﺩ‪.‬‬
‫• ﺩﺭ ﺳﺎﻋﺖ ‪ ،16‬ﺩﻳﻼﺗﺎﺳﻴﻮﻥ ﺳﺮﻭﻳﻜﺲ ‪ 7‬ﺳﺎﻧﺖ ﺍﺳﺖ ﻭ‬
‫ﻧﻤﻮﺩﺍﺭ ﺭﻭﻱ ﺧﻂ ﻓﻌﺎﻝ ﺑﻮﺩﻩ ﻭ ﺑﺎﻳﺪ ﺑﺮﺍﻱ ﺍﻗﺪﺍﻣﺎﺕ ﻻﺯﻡ‬
‫ﺗﺼﻤﻴﻢ ﮔﻴﺮﻱ ﺷﻮﺩ‪.‬‬