‫ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪carbetocinF‬أ و ا ﻟ ﻤ ﻨ ﻊ ‪-‬ا ﻟ ﺤ ﺮ ا ر ة‬

‫ﻣﻨﺒﻌﺪ اﻟﻮﻻدةاﻟﻨﺰف *‬

‫‪gl-pab-2100007‬‬
‫ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻜﻮﻧﺄﺷﺎرﺗﻠﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺎﻟﺮﺣﻤﺎﻟﻨﺰﻓﻨﻈﺮاإﻟﯩﺒﻌﺪ اﻟﻮﻻدةرﺣﻤﺸﻤﺎل ﺷﺮﻗﻐﻴﺮ ﻣﺸﺪد‪-.‬اﻟﺤﺮارة*‬ ‫اﻹ‪:january2022‬ﺗﺎرﻳﺨﻤﻨﺘﺤﻀﻴﺮ‬
‫‪.v.© 2021ferringb.v.‬ب‪ferring‬اﻷدوﻳﺔﺷﻌﺎرﻫﻼﻟﻌﻼﻣﺎت اﻟﺘﺠﺎرﻳﺔﻣﻦ‪ferring‬وال‪ferring‬‬ ‫‪:2.6‬ﺻﺪاررﻗﻢ‬
‫ﻟ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة )‪carbetocin( hsc‬ﻟ ﻠ ﺤ ﺼ ﻮ ل ﻋ ﻠ ﯩ ﺎ ﻟ ﻤ ﻨ ﻌ ﻤ ﻨ ﺒ ﻌ ﺪ ا ﻟ ﻮ ﻻ د ة ا ﻟ ﻨ ﺰ ف * )‪(pph‬‬

‫ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪carbetocin‬ﺗ ﺮ ﻳ ﻨ ﻴ ﻨ ﻐ ﻤ ﻮ ﺟ ﺰ ‪-‬ا ﻟ ﺤ ﺮ ا ر ة‬

‫ﻟﻸ ﻏ ﺮ ا ض ‪:‬‬
‫ﻟﻠﺤﺼﻮل ﻋﻠﯩﺘﻮﻗﺎل اﻧﻪ)‪(hsc‬ﻣﺴﺘﻘﺮة‪-carbetocin‬ﺗﺰوداﻓﻨﻴﺘﺤﺪﻳﺜﻌﻠﯩﺎﻟﺤﺮارة‬
‫ﻣﻨﻌﻤﻦ* ‪pph‬وﻗﻄﺎرﺻﺤﺔاﻟﻌﻨﺎﻳﺔﺷﺆون ﻣﻮﻇﻔﻴﻨﻔﻴﺪورﺗﻬﺎاﻻﺳﺘﺨﺪام‪.‬‬

‫‪-‬ﻗ ﻴ ﻤ ﺔ ﻣ ﻨ ﺎ ﻟ ﺤ ﺮ ا ر ة ‪clinical‬ﻋ ﺐ ء و ‪1pph‬و ﺣ ﺪ ة‬ ‫و ﺣ ﺪ ة ‪2‬ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻻ د ا ر ة ﻣ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة‬

‫‪etocin‬ﻣ ﺴ ﺘ ﻘ ﺮ ة [ﻛ ﺮ ب ]‬ ‫ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪carbetocin‬‬
‫أ ﻫﺪ ا ف‬ ‫أ ﻫﺪ ا ف‬
‫ﻓﻬﻢ‪:‬‬ ‫أﻋﺮف‪:‬‬
‫اﺳﺘﻌﻤﺎﻟﻤﻦ‪uterotonics‬ﻟﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻦ‪•،pph‬‬ ‫دﻻﻟﺔ•‬
‫•ﻣﻦ ﺿﻤﻨﻬﺎﻣﺆﺧﺮاﻣﻦ اﻟﺬى‪recommendati‬إﺿﺎﻓﺎت‬ ‫ﻣﻮاﻧﻊ•‬
‫اﻻﻫﻤﻴﺔﻣﻨﻨﻮﻋﻴﺔ ‪uterotonics‬‬ ‫اﻟﺠﺮﻋﺔوﻃﺮﻳﻘﺔﻣﻨﺎﻻدارة•‬
‫‪ pph‬ﻣﻦ ﻋﻠﻰﺗﻲ‪n‬ﺣﻮاء‪r‬ﻟﻠﺤﺼﻮل ﻋﻠﯩﺎل‪p‬‬ ‫ﻣﻌﺎﻟﺠﺔواﻟﺘﺨﺰﻳﻦ•‬
‫وﺿﻌﻤﻦ•‬ ‫ﺧﺼﺎﺋﺼﻤﻦ ذر‪ o‬دﻋﻠﻰ ‪acti o n‬‬ ‫‪hsc‬‬ ‫اﻹﺑﻼﻏﻤﻨﺎﻟﺴﻠﺒﻴﺔاﻟﻤﺨﺪراﺗﺮدود ﻓﻌﻞ•‬

‫‪.‬ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻜﻮﻧﺄﺷﺎرﺗﻠﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺎﻟﺮﺣﻤﺎﻟﻨﺰﻓﻨﻈﺮاإﻟﯩﺒﻌﺪ اﻟﻮﻻدةاﻟﺮﺣﻤﻐﻴﺮ ﻣﺸﺪد‪-‬اﻟﺤﺮارة*‬

‫‪carbetocin‬ﻋ ﺐ ء و ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪ │pph‬و ﺣ ﺪ ة‬

‫‪th‬أ ﺳ ﺒ ﺎ ﺑ ﻤ ﻨ ﺎﻷ ﻣ ﻬ ﺎ ت ‪dea‬‬

‫‪1‬ﻗ ﻴ ﺎ د ة أ ﺳ ﺒ ﺎ ﺑ ﻤ ﻨ ﺎ ﻟ ﻤ ﻮ ﺗ ﺒ ﻴ ﻨ ﺤ ﺎ ﻣ ﻠ ﻨ ﺴ ﺎ ء‬
‫ﻳﻜﻮﻧﺎﻟﻘﻴﺎدة‪pph‬‬
‫ﻣﺒﺎﺷﺮﺳﺒﺒﻤﻨﺎﻷﻣﻬﺎت‬ ‫‪28٪‬‬
‫‪ 1‬اﻟ ﻮ ﻓ ﻴﺎ ﺗ ﻔ ﻲ ﺟﻤ ﻴ ﻊ أ ﻧ ﺤﺎ ء ا ﻟﻌﺎ ﻟ ﻢ‬ ‫اﻟ ﻘﺎ ﺋﻤ ﺔ اﻟ ﻄﺒ ﻴ ﺔ ‪ -‬ﻗﺒﻞ‬
‫اﻟﻈﺮوﻓﺘ ﻔﺎﻗﻢ‬
‫‪27٪‬‬
‫ﺑ ﻮ ا ﺳ ﻄ ﺔ ﺣ ﻤ ﻞ ( ﻣ ﺜﻠ ﻤ ﺜ ﻞ‬ ‫ﺷﺪﻳﺪة اﻟﻨﺰﻳ ﻒ‪،‬‬
‫‪73٪‬ﻣﻨﺎﻟﺬي‬
‫‪،‬اﻟﻤﻼرﻳﺎ ‪،‬داء اﻟﺴﻜﺮي‬
‫ﻳ ﻜ ﻮ ﻧﺒﻌﺪ اﻟ ﻮ ﻻدة‬
‫)ﺑﺪاﻧﺔ ‪،‬ﻓﻴﺮوس ﻧﻘﺺ اﻟﻤﻨﺎﻋﺔ‬
‫ﻋﻠﻰ ﻣﺪى‪90٪‬ﻣﻨﺎﻟﻮﻓﻴﺎتﻣﻦ ﻋﻨﺪ‪pph‬‬ ‫اﻟﻨﺰف‬

‫اﻟﺸﺮق‪-‬واﻧﺨﻔﺎض‪-‬ﺗﺤﺪﺛﻔﻴﻤﻨﺨﻔﺾ‬
‫‪2‬اﻟﺪﺧﻠﺒﻠﺪان)‪(lmics‬‬ ‫‪3٪‬‬
‫د ﻣ ﺠﻠ ﻄﺎت‬
‫‪14٪‬‬
‫‪pregnancy-‬‬
‫‪8٪‬‬ ‫ﻳﺴﺒﺒﻬﺎ‬
‫ﻋﺎﻟﻴﺪم‬
‫اﻹ‬
‫ﺟﻬﺎ ﺿﻤ ﻀﺎﻋ ﻔﺎت‬ ‫ا ﻟ ﻀﻐ ﻂ‬
‫‪9٪‬‬
‫إﻋﺎﻗﺔ‬
‫‪11٪‬‬
‫اﻟﻌﺪوى‬
‫ﻋﻤﻠﻮأﺧﺮى‬
‫ﻣﺒﺎﺷﺮأﺳﺒﺎب‬

‫ﻻﻧﺴﻴﺘﺎﻟﻌﺎﻟﻤﻴﺔﺻﺤﺔ ‪2014‬؛‪. e323-e333.: 2‬وآﺧﺮونﷲ‪،‬ﻗﻞ‪1.l‬‬

‫‪2021).‬آﺧﺮاﻟﻮﺻﻮﻟﻴﻮﻟﻴﻮ (ﻗﻮات اﻟﺪﻓﺎع اﻟﺸﻌﺒﻲ ‪.‬اﻟﻤﻬﻨﺪس ‪-rhr-19.23-‬ﻣﻦ اﻟﺬى ‪/ 10665/327596 /‬ﻣﻘﺒﺾ ‪/Bitstream/‬اﻟﻘﺰﺣﻴﺔ ‪/‬اﻟﺒﺎﺣﺚ ‪.‬ﻣﻦ اﻟﺬى ‪.‬ﺗﻄﺒﻴﻘﺎت ‪:‬ﻣﺘﻮﻓﺮةﻓﻲ ‪.2019.‬اﻟﻌﺎﻟﻤﺼﺤﺔﻣﻨﻈﻤﺔ ‪2.‬‬
‫‪carbetocin‬ﻋ ﺐ ء و ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪ │pph‬و ﺣ ﺪ ة‬

‫اﻷ ﻣ ﻬ ﺎ ﺗ ﺎ ﻟ ﻤ ﺮ ا ﺿ ﺔ‬

‫ﻋ ﻮ ا ﻗ ﺒ ﻤ ﻨ ﺎﻷ ﻣ ﻬ ﺎ ت‬
‫ﺗﻤﺘﺎاﻟﺴﻠﺒﻴﺔﺗﺄﺛﻴﺮ أو ‪opph‬اﻷﻣﻬﺎﺗﺎﻟﻤﺮاﺿﺔﻧﻈﺮات‬ ‫‪2 ، 3‬ا ﻟ ﻤ ﻮ ﺗ ﻮ ﻗ ﺮ ﻳ ﺐ ﺗ ﻔ ﻮ ت‬

‫‪،their‬ﺗﺼﺎدﻣﻌﻠﯩﻨﺴﺎء‬ ‫اﻟﻌﻘﻢ‬
‫ﻻاﻟﺬﻳﻦ ﻳﻌﻴﺸﻮن‬
‫اﻟ ﻄ ﻔ ﻞ‬
‫اﻟﺘﺎﻟﻔ ﺔ اﻟ ﺤﻮﺿﻬ ﻴ ﻜ ﻞ‬

‫اﻷﺳﺮ‪،‬وﻣﺠﺘﻤﻌﺎﺗﻔﻲ‪lmics‬‬ ‫ﺿﻌ ﻒ‬
‫وﻇﻴ ﻔ ﺔ‬
‫ﻓﻘﺮ دم‬

‫ﻓﻮرﻳﺼﺤﺔﻣﻀﺎﻋﻔﺎﺗﻨﻈﺮاإﻟﻰ‪.pph‬‬ ‫ﻣﻨﺨﻔﺾ‬ ‫اﻟﺒﺪﻧﻴﺔ‬

‫اﻟﺰ وﺟﻴ ﺔاﻟﻤﺸﻜﻠ ﺔ‬

‫ﻗﻠﺒﺄواﻟﻜﻠﻮﻳﻔﺎﻳﺈﻏﺮاء‪،،‬ﺗﻀﻤﻦ‪hypovolaemic‬ﺻﺪﻣﺔ‬ ‫اﻻﻧﺘﺤﺎر‬

‫‪1‬واﻹﻧﺘﺎن‪)،‬اﺳﺘﺌﺼﺎل اﻟﺮﺣﻢ(ﺧﺴﺎرةﻣﻨﺎﻟﺨﺼﻮﺑﺔ‬ ‫اﻻ‬ ‫اﻟﻤﻨﺰﻟﻴﺔ اﻟ ﺤﻞ‬

‫ﻧﻔﺴﻲ‬
‫ﺎ‬
‫ﻋﻨﺪﻣﺎاأﻣﺨﺒﺮةﺷﺪﻳﺪةﻣﺮﺿﻴﺔ‪:،‬ﻣﺼﻄﻠﺤﻌﻮاﻗﺐ ‪-‬ﻃﻮﻳﻞ ‪.‬‬ ‫ﺿ ﻌ ﻔ ﺎﻹ ﻧ ﺘﺎ ﺟ ﻴ ﺔ‬

‫واﻻ‪،‬اﻟﻤﺎﻟﻴﺔ‪،‬ﻧﻔﺴﻲ‪،‬ﻓﺈﻧﻬﺎﻟﻨﺘﺎﺋﺠﻔﻴﺎﻟﺴﻠﺒﻴﺔاﻟﺒﺪﻧﻴﺔ‬ ‫اﻟﻮﺻﻢ‬

‫ﻳﻤﻜﻨﺄﻳﻀﺎﻳﻤﻠﻜﺎاﻟﺴﻠﺒﻴﺔﺗﺄﺛﻴﺮ أو ‪،which‬ﺟﺘﻤﺎﻋﻴﺔﻋﻮاﻗﺐ‬ ‫ﻧ ﻘ ﺼﻤ ﻨﻌ ﺎ ﺻﻤ ﺔ‬
‫اﻻﻗﺘﺼﺎدﻳﺔ‬

‫‪ly2-5‬ﺗﺼﺎدﻣﻌﻠﯩﻠﻬﺎ‪fami‬‬ ‫اﻻﺟﺘﻤﺎﻋﻴﺔﻋﺰل‬
‫ﻻ ﻣ ﺪ ﺧ ﺮ ات‬
‫‪5 (3)28-34.‬اﻟﺪوﻟﻴﺔﻣﺠﻠﺔﻣﻨﺘﻤﺮﻳﻀﻮاﻟﻘﺒﺎﻟﺔ‪.(2013).‬وآﺧﺮونﷲ‪،‬أ‪.‬ﻫﺎء‪1.olowokere،‬‬
‫اﻟﻬ ﺠﺮة‬
‫ﻋﺪد اﻟﺴﻜﺎﻧﻤﺮﺟﻌﻤﻜﺘﺐ‪2.immpact(2007).(prb).‬‬ ‫اﻟ ﺪﻳ ﻮ ن‬
‫‪368 (9546)1535-1541.‬اﻟﻼﻧﺴﻴﺖ ‪ ،. (2006).‬ﺧﺎ ﻣﺴ ﺎ ‪ ،c،:‬وآﺧﺮونﷲ‪3.filippi‬‬
‫اﻟﻔﻘﺮ‬
‫‪370: 1329-37.‬اﻟﻼﻧﺴﻴﺖ ‪ ،. (2007).‬ﺧ ﺎ ﻣ ﺴ ﺎ ‪ ،:‬وآﺧﺮونﷲ‪4.filippi‬‬
‫‪30 (2): 226-240.‬ﻣ ﺠ ﻠ ﺔ ﻣ ﻨ ﺎ ﻟ ﺼ ﺤ ﺔ ‪ ،‬ﻋ ﺪ د ا ﻟ ﺴ ﻜ ﺎ ﻧ ﻮ ﺗ ﻐ ﺬ ﻳ ﺔ ‪(2012).‬و آ ﺧ ﺮ و ن ﷲ‪.، .‬ك‪5.iyengar،‬‬
 ‫‪carbetocin‬ﻋ ﺐ ء و ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪ │pph‬و ﺣ ﺪ ة‬

‫ﻣ ﻌ ﺪ ل ا ﻟ ﻮ ﻓ ﻴ ﺎ ت *ﻃ ﻔ ﻞ ر ﺿ ﻴ ﻊ‬

‫اﻷﻣﻬﺎﺗﻤﻌﺪل اﻟﻮﻓﻴﺎﺗﻮاﻟﻤﺮاﺿﺔﺿﻌﺎﻷﻃﻔﺎل‬
‫ﻓﻴﻌﻈﻴﻤﺨﻄﺮﻣﻨﺎﻟﻤﻮت‬
‫‪1-4‬اﻷﻣﻬﺎﺗﻤﻌﺪل اﻟﻮﻓﻴﺎﺗﻴﻜﻮﻧﺎﻟﻤﺮﺗﺒﻄﺔﻣﻌﻌﺎﻟﻴﻄﻔﻞ رﺿﻴﻌﻤﻌﺪل اﻟﻮﻓﻴﺎت‪.‬‬
‫ﻟﺨﺴﺎرةﻳﻤﻜﻨﺘﺪﻣﺮال ‪er‬دﻟﻴﻠﺘﻤﺘﻮﺟﺪﺗﺄﻧﺎﻓﺮاﺷﺔ‪.‬‬
‫وﻧﺠﺎةﻓﺮﺻﻤﻨﻬﺆﻻءﻫﻲ‪،‬ﻧﻮﻋﻴﺔﻣﻨﺤﻴﺎة‪،‬ﺳﺒﻞ اﻟﻌﻴﺶ‬
‫‪5-8‬اوراﻗﺨﻠﻒ‬
‫اﻷﻃﻔﺎﻟﻤﻦ اﻟﺬﯨﺨﺒﺮةدﻋﻠﯩﻔﻲ وﻗﺖ ﻣﺒﻜﺮاﻷﻣﻬﺎﺗﺎﻟﻤﻮﺗﻬﻠﻔﻲ‪.15‬‬
‫‪9‬ﻣﺮةاﻟﺨﻄﺮﻣﻨﺎﻟﻤﻮت‬
‫اﻟﺘﻮﻟﻴﺪﻣﻀﺎﻋﻔﺎﺗﺎﻟﻮﺟﻪ‪e‬اﻟﺮﺿﻌﻤﻨﻨﺴﺎءأن‪.experienc‬‬
‫‪10-13‬زﻳﺎدةﺧﻄﺮﻣﻨﺎﻟﻤﻮت‬
‫*اﻟﺮﺿﻊ =اﻟﻄﻔﻠﻔﻲ ﻇﻞ ‪1‬ﻋﺎﻣﻘﺪﻳﻢ ‪.‬‬
‫‪lth12،s4.‬اﻹ ﻧ ﺠ ﺎ ﺑ ﻴ ﺔ ‪ ،. (2015).hea‬ﺟ ﻴ ﻢ ‪ ،‬و آ ﺧ ﺮ و ن ﷲ ‪1.moucheraud‬‬ ‫و آ ﺧ ﺮ و ن ﷲ ‪. (2015).‬اﻹ ﻧ ﺠ ﺎ ﺑ ﻴ ﺔ ﺻ ﺤ ﺔ ‪12‬ا ﻟ ﻤ ﻠ ﺤ ﻖ ( ‪1‬ا ﻟ ﻤ ﻠ ﺤ ﻖ )‪.،s3. ،1‬أ ‪7.kes،‬‬
‫ا ﻟ ﺪ و ﻟ ﻴ ﺔ ‪cen‬ﺛ ﺎ ﻟ ﺜ ﺎ ﻟ ﻠ ﺤ ﺼ ﻮ ل ﻋ ﻠ ﯩ ﺎ ﻟ ﺒ ﺤ ﺜ ﻌ ﻠ ﯩ ﻨ ﺴ ﺎ ء )‪(icrw‬و ‪(2014).‬ﻋ ﺎ ﺋ ﻠ ﺔ ا ﻟ ﻌ ﻨ ﺎ ﻳ ﺔ ا ﻟ ﺪ و ﻟ ﻴ ﺔ ‪2.‬‬ ‫و آ ﺧ ﺮ و ن ﷲ ‪. (2015).‬اﻹ ﻧ ﺠ ﺎ ﺑ ﻴ ﺔ ﺻ ﺤ ﺔ ‪.،s6. ،12‬م ‪8.molla،‬‬
‫‪.‬اﻟﻤﺮاﻛﺰاﻟﺒﺤﺜﻮﻋﺎﻣﺔﺻﺤﺔاﻟﺘﻌﺎون‪kemri/‬‬ ‫‪.‬ا ﻟ ﺼ ﺤ ﺔ ‪(2015).reprod‬و آ ﺧ ﺮ و ن ﷲ ‪.، .‬ب ‪9.houle‬‬
‫‪(2)e0172286.‬و ا ﺣ ﺪ ‪(20 17).plos12‬ﺳ ﻜ ﻮ ت ‪ ،‬س ‪ ،.‬و آ ﺧ ﺮ و ن ﷲ ‪3 . .‬‬ ‫‪(prb).‬ﻋﺪد اﻟﺴﻜﺎﻧﻤﺮﺟﻌﻤﻜﺘﺐ ‪10.immpact(2007).‬‬
‫‪3 7 5 ( 9 7 3 0 ) 2 0 2 4 - 2 0 3 1 .‬ﻻﻧﺴﻴﺖ ‪ ،. ( 2 0 1 0 ) .‬ﺟ ﻴ ﻢ ‪ ،‬وآﺧﺮونﷲ‪4 . ronsmans‬‬ ‫و آ ﺧ ﺮ و ن ﷲ ‪. (2006).‬ا ﻟ ﻼ ﻧ ﺴ ﻴ ﺘ ﺎ ﻟ ﻤ ﺠ ﻠ ﺪ ‪ ،368‬ا ﻟ ﻘ ﻀ ﻴ ﺔ ‪:،9546.‬ﺧ ﺎ ﻣ ﺴ ﺎ ‪11.filippi،‬‬
‫‪alth12،s1.‬اﻹ ﻧ ﺠ ﺎ ﺑ ﻴ ﺔ و ﻗ ﺎ ل ا ﻧ ﻪ ‪ ،. (2015).‬ﻳ ﺎ ء ‪ ،‬و آ ﺧ ﺮ و ن ﷲ ‪5.bazile‬‬ ‫‪3 7 0 ( 9 5 9 5 ) 1 3 2 9 - 1 3 3 7 .‬ﻻﻧﺴﻴﺖ ‪ ،. ( 2 0 0 7 ) .‬ﺧ ﺎ ﻣ ﺴ ﺎ ‪ ، :‬وآﺧﺮونﷲ‪1 2 . filippi‬‬
‫‪1)s 2-s 2.‬اﻟﻤﻠﺤﻖ ( ‪1‬اﻟﻤﻠﺤﻖ ‪12‬ﺻﺤﺔ‪. (2015).reprod‬ﺑﺎﻧﺪي‪،‬ر ‪ ،.‬وآﺧﺮونﷲ ‪6 .‬‬ ‫‪populnutr30 (2)226-240.‬ﺻﺤﺔ‪،. (2012).j‬ك ‪ ،.‬وآﺧﺮونﷲ‪13.iyengar‬‬
‫‪carbetocin‬ﻋ ﺐ ء و ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪ │pph‬و ﺣ ﺪ ة‬

‫اﻻ ﻗ ﺘ ﺼ ﺎ د ﻳ ﺔ ﺧ ﻄ ﺮ‬

‫اﻻﻗﺘﺼﺎدﻳﺔ‪ificant‬إﺧﻔﺎﻗﺈﻟﯩﻴﻤﻨﻊ‪pph‬ﻳﺸﻜﻼإﺷﺎرة‬
‫ﻋﺐءإﻟﯩﺎﻷﺳﺮواﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔأﻧﻈﻤﺔ‬

‫ﻳﻐﻴﺐ‪e‬ﺗﻨﻔﻴﺲ‪-‬اﻷﺳﺮﻣﻦ اﻟﺬﯨﺨﺒﺮةااﻷﻣﻬﺎﺗﺎﻟﻤﻮﺗﺄواﻗﺮﻳﺒﺔ‪.‬‬
‫ﺧﻼﻟﻌﻤﻠﻮﺑﻌﺪ اﻟﻮﻻدةاﻟﻔﺘﺮةﻳﻘﻀﻴﺠﻮﻫﺮﻳﺎاﻟﻤﺰﻳﺪﻋﻠﻰ‬
‫‪1-3‬اﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔﻣﻨﻬﺆﻻءﻣﻨﻌﻠﯩﻐﻴﺮ ﻣﻌﻘﺪةوﻻدة‬
‫‪alth‬إﺧﻔﺎﻗﺈﻟﯩﻴﻤﻨﻊ‪pph‬ﻳﺸﻜﻠﻜﺒﻴﺮﺗﻜﺎﻟﻴﻔﺈﻟﯩﻮﻗﺎل اﻧﻪ‪.‬‬
‫إﻟﻰ ﺣﺪ ﻛﺒﻴﺮﻣﺪﻓﻮﻋﺔﺑﻮاﺳﻄﺔاﻟﻜﻠﻔﺔﻣﻨﺪم‪transfusi‬اﻟﻤﻜﺘﺐ‪،‬ﺟﺮاﺣﺔ‪،،‬أﻧﻈﻤﺔ‬
‫‪4-8‬وﺗﻤﺪﻳﺪﻳﺒﻘﯩﻔﻴﺎﻟﺮﻋﺎﻳﺔ اﻟﺼﺤﻴﺔﻣﺮاﻓﻘﺄو‪hospit‬اﻟﻤﺮض‬

‫ﻧﺸﺮس ‪ /‬أﻟﻒ اﻟﺴﻌﺮ أﻳﻀﺎاﻟﺮﻓﻴﻊ إﻟﻰ ﺗﺤﻤﻞ رأس ﺗﻜﺎﻟﻴﻒ‪-‬ﻣﻦ‪-‬اﻷﻣﻬﺎت‪-‬وﻓﻴﺎت إﻟﻰ اﻷﺳﺮ‪-‬و‪-‬اﻟﻤﺠﺘﻤﻌﺎت ‪//‬اﻟﻤﺆ ﺳﺴﺔ ‪.icrw.‬ﺷﺒﻜﺔ اﻻﺗﺼﺎﻻت اﻟﻌﺎﻟﻤﻴﺔ ‪:https: //‬ﻣﺘﻮﻓﺮةﻓ ﻲ ‪.(2014).icrw.‬ﻋﺎﺋﻠﺔ اﻟﻌﻨﺎﻳﺔ اﻟﺪوﻟﻴﺔ ‪1.‬‬
‫‪1):s3.‬ا ﻟ ﻤ ﻠ ﺤ ﻖ (‪12‬اﻹ ﻧ ﺠ ﺎ ﺑ ﻴ ﺔ ﺻ ﺤ ﺔ ‪).‬أ ‪ ،.‬و آ ﺧ ﺮ و ن ﷲ ‪2.kes،.(2015‬‬
‫ﺑﻮرﻛﻴﻨﺎﻓﺎﺳﻮ‪15 /poppov-factsheet.pdf-‬ﻗﻮ ات اﻟﺪﻓﺎع اﻟﺸﻌﺒﻲ ‪/‬اﻟﻤ ﺆﺳﺴ ﺔ ‪.prb.‬اﻷﺻﻮ ل ‪:https: //‬ﻣﺘﻮﻓﺮةﻓﻲ ‪.‬ﻋﺪد اﻟﺴﻜﺎﻧﻮ اﻟﻔﻘﺮ اﻟﺒﺤﺜﺸﺒﻜ ﺔ ‪3.poppov.(2015).‬‬
‫‪r24 (4):540-551.‬اﻟﺒﻨﺪق‪popul‬ﺻﺤﺔ‪،.(2006).j‬ج‪.‬ت‪،‬وآﺧﺮونﷲ‪4.fullerton‬‬
‫‪210:286-291‬ﻳﻮرو‪.(2017).jobstetgynecolreprodbiol‬ﻓﺎﻧﺪﻳﺮﻧﻴﻠﺴﻮن‪،‬ه‪.‬أﻟﻒ‪،‬وآﺧﺮونﷲ‪5.‬‬
‫‪5 (3)28-34.‬اﻟﺪوﻟﻴﺔﻣﺠﻠﺔﻣﻨﺘﻤﺮﻳﻀﻮاﻟﻘﺒﺎﻟﺔ ‪،.(2013).‬أ ‪.‬ﻫ ﺎ ء ‪ ،‬وآﺧﺮونﷲ‪6.olowokere‬‬
‫‪ng 24،438-44.‬ﺻ ﺤ ﺔ ﺳ ﻴ ﺎ ﺳ ﺔ و ‪.(2009). planni‬ﺗ ﺴ ﻮ ‪ ،‬ﺧ ﺎ ﻣ ﺴ ﺎ ‪:‬د ‪ ،.‬و آ ﺧ ﺮ و ن ﷲ ‪7.‬‬
‫‪ndation.‬ا ﻟ ﻤ ﻔ ﻬ ﻮ م ‪،).fou‬أ (‪.‬ﻏ ﻴ ﺮ ﻣ ﻨ ﺸ ﻮ ر ة ‪،ulmezoglu‬ف ‪.‬و ‪8.theunisseng‬‬
‫‪hsc‬ﻋ ﺐ ء و ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻦ ‪ │pph‬و ﺣ ﺪ ة‬

‫‪rrier‬ا ﻟ ﺘ ﻐ ﻠ ﺐ ﻋ ﻠ ﯩ ﺎﻻ ﻟ ﺤ ﺮ ا ر ة د ر ﺟ ﺔ ا ﻟ ﺒ ﻜ ﺎ ﻟ ﻮ ر ﻳ ﻮ س‬
‫إ ﻟ ﯩ ﻴ ﻤ ﻨ ﻊ ‪pph‬‬

‫اﻷﻏﻠﺒﻴﺔﻣﻨﺎﻟﻮﻓﻴﺎﺗﻤﻦ ﻋﻨﺪ‬
‫ﻧﻈﺮاإﻟﯩﺎﻟﺮﺣﻤﻐﻴﺮ ﻣﺸﺪد‪pph‬‬
‫‪ 1‬ا ﺳ ﺘ ﻄ ﺎﻋ ﻜ ﻨ ﻤ ﻨ ﻊ‬
‫ال• اﻟﺤﺎﻟﻴﻤﻌﻴﺎرﻣﻨﺎﻟﻌﻨﺎﻳﺔ‪،‬ﻟﻜﻨﺎﻷوﻛﺴﻴﺘﻮﺳﻴﻦ‪.‬‬
‫ﻧﻴﺪ أﻧﺎ ﺳﺘﺎ سس إﻋﺎدة ‪ot o n ic، req ui‬ﺛﺎﻟﺜﺎ‪u‬‬ ‫اﻟﻌﻼج ﺑﺎﻹﻣﺎﻫﺔ اﻟﻔﻤﻮﻳﺔ‪p‬سﻋﻠﻰ ‪r‬ت‪n‬أﻧﺎﻗﺪﻳﻢ‪-‬ﺗﺸﺎ‪c‬‬
‫‪ o r،‬ﻓﻲ‪ ge r‬أﻧﺎ ﻓﻴﺎ‪y refr‬ﻣﻜﺎﻟﻤﺔأﻧﺎاﻟﻄﺒﺎع ‪2- 8 c‬ﻓﻲ ‪rage‬إﻟﻰس ‪ nd‬ا‬
‫‪°‬‬

‫‪1،2‬إﻟﯩﺎﻟﺤﻔﺎﻇﺪورﺗﻬﺎﻓﻌﺎﻟﻴﺔ‬

‫‪-‬واﻟﺸﺮق‪-‬ﻫﺬﻫﻴﺸﻜﻼﺗﺤﺪﻓﻴﺎﻟﻌﺪﻳﺪ ﻣﻨﻤﻨﺨﻔﺾ‪.‬‬
‫اﻟﺪﺧﻼﻟﺒﻠﺪان‪،‬أﻳﻨﺎﻟﻮﺻﻮﻹﻟﯩﺎﺳﺘﻤﺮار‬
‫اﻟﺒﺎردة ﺳﻠﺴﻠﺔاﻟﺘﺨﺰﻳﻨﻤﺎﻳﻮﻟﻴﺴﻜﻨﺒﺴﻬﻮﻟﺔﻣﺘﻮﻓﺮة‬ ‫‪1‬‬
‫ﻗﻞ‪،l‬وآﺧﺮونﷲ‪.‬ﻻﻧﺴﻴﺘﺎﻟﻌﺎﻟﻤﻴﺔﺻﺤﺔ‪2014‬؛‪1.333.- 323: 2‬‬
‫‪ua= 1‬ﻗﻮات اﻟﺪﻓﺎع اﻟﺸﻌﺒﻲ؟‪.‬اﻟﻤﻬﻨﺪس ‪/ 10665/277276 / 9789241550420-‬ﻣﻘﺒﺾ ‪/Bitstream/‬اﻟﻘﺰﺣﻴﺔ ‪/‬اﻟﺒﺎﺣﺚ ‪.‬ﻫﻮ‪.w‬ﻣﺘﻮﻓﺮةﻓﻴﺘﻄﺒﻴﻘﺎت ‪(2018).‬اﻟﻌﺎﻟﻤﺼﺤﺔﻣﻨﻈﻤﺔ ‪2.‬‬
‫‪2021).‬ﻳﻮﻟﻴﻮ ‪:‬آﺧﺮاﻟﻮﺻﻮل (‪&ua= 1‬‬
‫‪016، 17: 143.‬م‪،‬وآﺧﺮونﷲ‪.‬اﻟﻤﺤﺎﻛﻤﺎت‪3.widmer2‬‬
‫‪3: 2076-2086.‬؛‪.bjog2016 12‬اﻟﺴﻴﺪ‪،‬وآﺧﺮونﷲ‪4.torloni‬‬
‫‪2021).‬ﻳﻮﻟﻴﻮ ‪:‬آﺧﺮاﻟﻮﺻﻮل (ﻗﻮات اﻟﺪﻓﺎع اﻟﺸﻌﺒﻲ ‪/ch6_16pph.‬اﻷدوﻳﺔ _أﻓﻀﻠﻴﺔ ‪/‬اﻟﻤﻨﺎﻃﻖ ‪/‬اﻷدوﻳﺔ ‪/‬اﻟﺒﺎﺣﺚ ‪.‬ﻣﻦ اﻟﺬى ‪:www.‬ﻣﺘﻮﻓﺮةﻓﻲ ‪.‬اﻟﻌﺎﻟﻤﺼﺤﺔﻣﻨﻈﻤﺔ ‪5.‬‬
‫اﻟﻌﺎﻟﻤﺼ ﺤﺔاﻟﻤﻨﻈﻤﺔ ‪.‬ﻣﺘﻮﻓﺮةﻓﻲ‪6.:‬‬
‫‪202 1).‬ﻳﻮﻟﻴﻮ ‪:‬آﺧﺮاﻟﻮﺻﻮل (‪ua= 1‬ﻗﻮات اﻟﺪﻓﺎع اﻟﺸﻌﺒﻲ؟ ‪_infographic.‬ﻟﺠﻨﺔ ﻣﻜﺎﻓﺤﺔ اﻹرﻫﺎب _ﻣﻦ اﻟﺬى ‪/‬ﻣﻮارد ‪/‬ﺳﻠﺴﻠﺔ _اﻟﻌﺮض ‪/‬أﻧﻈﻤﺔ _ﺑﺮاﻣﺞ ‪/‬اﻟﺘﺤﺼﻴﻦ ‪/‬اﻟﺒﺎﺣﺚ ‪.‬ﻣﻦ اﻟﺬى ‪www.‬‬
‫اﻟﻤﻨﺎﻇﺮ اﻟﻄﺒﻴﻌﻴﻬﺘﺤﻠﻴﻠﻮ ‪.‬اﻟﺘﺤﺼﻴﻨﺎﻟﻌﺮﺿﺴﻠﺴﻠﺔﺳﻴﺎﺳﺔاﻟﺒﻴﺌﺔﻓﻴﻮأوﻏﻨﺪا ‪8 .‬اﻟﺒﻴﻮﻟﻮﺟﻴﺔ ‪20 17‬؛ ‪. 12 4 . - 11 7 :50‬وآﺧﺮونﷲ ‪7 . kartogluu،‬‬
‫‪).‬آ ﺧ ﺮ ا ﻟ ﻮ ﺻ ﻮ ﻟ ﻴ ﻮ ﻟ ﻴ ﻮ ‪:www.path.org/publications/files/app_landscape_analysis_uganda_rpt.pdf(2021‬ﻣ ﺘ ﻮ ﻓ ﺮ ة ﻓ ﻲ ‪.‬ا ﻟ ﺪ ﻋ ﻮ ة ا ﻟ ﺘ ﻮ ﺻ ﻴ ﺎ ت‬
‫‪carbetocin‬ﻋ ﺐ ء و ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪ │pph‬و ﺣ ﺪ ة‬

‫ا ﻟ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪uterotonic‬‬

‫ﻫﻠﻠﻴﺴﺘﺤﺘﺎﺟﺈﻟﯩﻜﻨﺎﻟﻤﻮاﺻﻼﺗﺈدأوﻣﺨﺰن‪.hsc‬‬
‫ﻓﻲ‪c°8-2‬‬
‫أﺷﻬﺮﻋﻨﺪﻣﺎﻣﺨﺰﻧﺄدﻧﺎه‪48‬ﻳﻜﻮﻧﻤﺴﺘﻘﺮةﻟﻠﺤﺼﻮل ﻋﻠﻰ‪.hsc‬‬
‫‪)1‬ﻟﻜﻨﻠﻴﺴﺎﻟﻤﺠﻤﺪة(‪30° c‬‬
‫ﻫﻠﻠﻴﺴﻴﺘﻄﻠﺒﺘﺒﺮﻳﺪ‪،‬اﻟﺤﺪ‪.hsc‬‬
‫ﺗﺸﺎﻓﻴﺎﻟﻤﻮاﺻﻼﺗﻮ‪-‬اﻟﻀﻐﻄﻌﻠﯩﻬﺸﺔاﻟﺒﺎردة‬
‫‪cs2‬ﻣﺒﺮدةاﻟﺘﺨﺰﻳﻨﺒﻨﻴﺔ ﺗﺤﺘﻴﺔﻓﻲ‪lmi‬‬

‫‪/‬؟ ﻻﻧﻎ = أون (آﺧﺮاﻟﻮﺻﻮﻟﻴﻮﻟﻴﻮ ‪.swissmedicinfo.ch2021).‬ﺷﺒﻜﺔ اﻻﺗﺼﺎﻻت اﻟﻌﺎﻟﻤﻴﺔ ‪https: //‬ﻣﻠﺨ ﺼﻤﻨﺎﻟﻤﻨﺘ ﺠﺨﺼﺎﺋﺺ ‪1.carbetocinferring‬‬
‫‪: 1 0 . 1 0 5 6 / nejmoa1 8 0 5 4 8 9 .‬دوي ‪:‬ﻣﺘﻮﻓﺮةﻓﻲ ‪3 7 9 ، 7 4 3 - 7 5 2 .‬ﺟﺪﻳﺪاﻧﺠﻠﺘﺮاﻣﺠﻠﺔﻣﻨﺎﻟﺪواء ‪ ،. ( 2 0 1 8 ) .‬م ‪ ،‬وآﺧﺮونﷲ‪2 . widmer‬‬
‫‪carbetocin‬ﻋ ﺐ ء و ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪ │pph‬و ﺣ ﺪ ة‬

‫ﻟ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪carbetocin‬ﻳ ﻜ ﻮ ﻧ ﻤ ﺨ ﺘ ﻠ ﻔ ﻤ ﻦ ﻋ ﻨ ﺪ اﻷ و ﻛ ﺴ ﻴ ﺘ ﻮ ﺳ ﻴ ﻦ‬

‫‪1‬ﻳﻜﻮﻧﺎﻃﻮﻳﻼﻟﺘﻤﺜﻴﻼﻻﺻﻄﻨﺎﻋﻴﺔاﻟﺘﻨﺎﻇﺮﻳﺔﻣﻨﺎﻷوﻛﺴﻴﺘﻮﺳﻴﻨﺜﺎﺗﻌﻘﻮداﻻﻟﺮﺣﻢ‪.carbetocin‬‬
‫ﻟﻠﺤﺼﻮل ﻋﻠﯩﻜﻼﻟﻮﻻ‪pph‬اﻟﺪﻋﻤﺎﻻﺳﺘﻌﻤﺎﻟﻤﻦ‪carbetocin‬ﻓﻴﺎﻟﻤﻨﻌﻤﻦ‪1‬ﻣﻦ اﻟﺬﯨﺎﻟﺘﻮﺻﻴﺎت‪2018‬ال‪.‬‬
‫ﻳﻜﻮﻧﻤﻮﺻﻰ ﺑﻬﻔﻴﺎﻹﻋﺪاداﺗﺄﻳﻨﺎﻷ‪carbetocin‬داﺗﻔﻴﺎﻟﺴﻴﺎﻗﺎﺗﺄﻳﻨﺪورﺗﻬﺎﻛﻠﻔﺔﻳﻜﻮﻧﻤﻤﺎﺛﻠﺔإﻟﯩﺄﺧﺮﯨﻔﻌﺎل‪uterotonics.‬‬
‫وﻛﺴﻴﺘﻮﺳﻴﻨﻴﻜﻮﻧﻐﻴﺮ ﻣﺘﻮﻓﺮﻫﺄودورﺗﻬﺎﻧﻮﻋﻴﺔ‬
‫ﻛﻨﻤﻀﻤﻮن‪cannot‬‬
‫‪2‬ﺗﻤﺘﺘﻤﻮأﺿﺎﻓﺈﻟﯩﺎﻟﻤﻦ اﻟﺬﯨﻨﻤﻮذﺟﻘﺎﺋﻤﺔﻣﻨﺎﻷﺳﺎﺳﻴﺔاﻷدوﻳﺔ‪.carbetocin‬‬
‫ﻟﻠﺤﺮارة ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻜﻮﻧﻮاﻓﻘﻠﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺎﻟﺮﺣﻤﺎﻟﻨﺰﻓﻨﻈﺮاإﻟﯩﺒﻌﺪ اﻟﻮﻻدةاﻟﺮﺣﻤﻐﻴﺮ ﻣﺸﺪداﻟﺘﺎﻟﻴﻮﻻدة ‪.‬‬
‫‪3‬ﻗﻴﺼﺮﻳﺔﻗﺴﻢ&اﻟﻤﻬﺒﻠﻴﺔﺧﺪﻣﻪ ﺗﻮﺻﻴﻞ(ﻓﻲ إﻃﺎراﻟﺠﺪﻳﺪ‪swissmedic‬و* ‪maghp‬اﻹﺟﺮاء)‬

‫‪.‬اﻟﺴﻮﻳﺴﺮﻳﺎﻟﺘﺴﻮﻳﻘﺘﻔﻮﻳﻀﻠﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻌﺎﻟﻤﻴﺔﺻﺤﺔاﻟﻤﻨﺘﺠﺎت ‪*maghp:‬‬

‫‪: 1 0 . 1 0 5 6 / nejmoa1 8 0 5 4 8 9 .‬دوي ‪:‬ﻣﺘﻮﻓﺮةﻓﻲ ‪3 7 9 ، 7 4 3 - 7 5 2 .‬ﺟﺪﻳﺪاﻧﺠﻠﺘﺮاﻣﺠﻠﺔﻣﻨﺎﻟﺪواء ‪ ،. ( 2 0 1 8 ) .‬م ‪ ،.‬وآﺧﺮونﷲ‪1 . widmer‬‬
‫ا ﻟ ﻌ ﺎ ﻟ ﻤ ﺼ ﺤ ﺔ ﻣ ﻨ ﻈ ﻤ ﺔ ﻧ ﻤ ﻮ ذ ﺟ ﻘ ﺎ ﺋ ﻤ ﺔ ﻣ ﻨ ﺎﻷ ﺳ ﺎ ﺳ ﻴ ﺔ اﻷ د و ﻳ ﺔ ‪ ،‬ا ل ‪21‬ﻗ ﺎ ﺋ ﻤ ﺔ ‪2019. ،‬ﺟ ﻨ ﻴ ﻒ ‪ :‬ا ﻟ ﻌ ﺎ ﻟ ﻤ ﺼ ﺤ ﺔ ا ﻟ ﻤ ﻨ ﻈ ﻤ ﺔ ؛ ‪2.2019.‬‬
‫‪-‬اﻟﻤﻮاﻓﻘﺔ ‪ maghp‬اﻟﺘﺼﺎرﻳﺢ ‪ /‬اﻟﻤﻌﻠﻮﻣﺎت ‪ /‬اﻷوﻟﻰ ‪anarzneimittel /‬ﻫﻤﻬﻤ ﺔ ‪/‬اﻟﺼﻔﺤ ﺔ اﻟﺮ ﺋﻴﺴﻴﺔ ‪/‬أون ‪.swissmedic.ch/swissmedic/‬ﺷﺒﻜﺔ اﻻﺗﺼﺎﻻت اﻟﻌﺎﻟﻤﻴﺔ ‪:‬ﻣﺘﻮﻓﺮةﻓﻲ ‪.‬أوﻻ‪maghp‬ﻣﻮ اﻓﻘﺔﻓﻴﺴﻮﻳﺴﺮ ا ‪3.swissmedic.‬‬
‫‪2021).‬ﻳﻮﻟﻴﻮ ‪:‬آﺧﺮاﻟﻮﺻﻮل(‪inswitzerland.html‬‬
‫‪carbetocin‬ﻋ ﺐ ء و ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪ │pph‬و ﺣ ﺪ ة‬

‫]‪[1 /2‬ﻣ ﻦ ا ﻟ ﺬ ﯨ ﺎ ﻟ ﺘ ﻮ ﺻ ﻴ ﺎ ت‬

‫ﻟﻠﺤﺮارة ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻜﻮﻧﺎﻵﻧﺒﻴﻨﺎل‪uterotonics‬‬
‫‪pph‬ﻣﻦ‪ntion‬ﻣﻮﺻﻰ ﺑﻬﺒﻮاﺳﻄﺔﻣﻦ اﻟﺬﯨﻠﻠﺤﺼﻮل ﻋﻠﯩﺎل‪preve‬‬
‫‪ 1‬اﻟﺘ ﻮ ﺻﻴ ﺔ‬
‫اﻻﺳﺘﻌﻤﺎﻟﻤﻨﻌﻠﯩﻔﻌﺎل‪uterotonic‬ﻟﻠﺤﺼﻮل ﻋﻠﯩﺎل‬
‫ﻣﻨﻌﻤﻦ‪pph‬ﺧﻼﻻﻻﻟﺜﺎﻟﺜﺎﻟﻤﺴﺮح‬
‫ﻣﻨﻌﻤﻠﻴﻜﻮﻧﻤﻮﺻﻰ ﺑﻬﻠﻠﺤﺼﻮل ﻋﻠﯩﻜﻼﻟﻤﻮاﻟﻴﺪ‪.‬‬
‫إﻟﯩﻌﻠﻰ ﻧﺤﻮ ﻓﻌﺎﻟﻴﻤﻨﻊ‪،pph‬ﻓﻘﻄﻮاﺣﺪﻣﻨﺎل‬
‫‪:1‬اﻟﺘﺎﻟﻲ‪uterotonics‬ﻳﻨﺒﻐﻴﻜﻨﻤﺴﺘﻌﻤﻠﺔ‬
‫‪1.‬اﻷوﻛﺴﻴﺘﻮﺳﻴﻦ‬
‫*‪2.carbetocin‬‬
‫اﻟﻤﻴﺰوﺑﺮوﺳﺘﻮل‪3.‬‬
‫‪4.ergometrine/methylergometrine‬‬
‫‪-‬اﻷوﻛﺴﻴﺘﻮﺳﻴﻨﻮ‪ergometrine‬اﻟﺜﺎﺑﺘﺔ ‪5.‬‬
‫اﻟﺠﺮﻋﺔﻣﺰﻳﺞ‬

‫‪.‬ﻧﻈﺮاإﻟﯩﺒﻌﺪ اﻟﻮﻻدةاﻟﺮﺣﻤﻐﻴﺮ ﻣﺸﺪد ‪hage‬ﻣﺴﺘﻘﺮة ‪carbetocin‬ﻳﻜﻮ ﻧﺄﺷﺎرﺗﻠﻠﺤﺼﻮ ل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺎﻟﺮ ﺣﻢ ‪-haemorr‬اﻟﺤﺮ ارة *‬

‫ا ﻟ ﻌ ﺎ ﻟ ﻤ ﺼ ﺤ ﺔ ا ﻟ ﻤ ﻨ ﻈ ﻤ ﺔ ‪.‬ﻣ ﻦ ا ﻟ ﺬ ﯨ ﺎ ﻟ ﺘ ﻮ ﺻ ﻴ ﺎ ت ‪.uterotonics‬ﻟ ﻠ ﺤ ﺼ ﻮ ل ﻋ ﻠ ﯩ ﺎ ﻟ ﻤ ﻨ ﻌ ﻤ ﻨ ﺒ ﻌ ﺪ ا ﻟ ﻮ ﻻ د ة ا ﻟ ﻨ ﺰ ﻳ ﻒ ‪1..2018.‬‬
‫‪carbetocin‬ﻋ ﺐ ء و ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪ │pph‬و ﺣ ﺪ ة‬

‫]‪[2 /2‬ﻣ ﻦ ا ﻟ ﺬ ﯨ ﺎ ﻟ ﺘ ﻮ ﺻ ﻴ ﺎ ت‬

‫‪1.1‬اﻟﺘﻮﺻﻴﺔ‬ ‫‪ 3‬اﻟﺘ ﻮ ﺻﻴ ﺔ‬
‫‪،‬اﻻﺳﺘﻌﻤﺎﻟﻤﻨﺎﻷوﻛﺴﻴﺘﻮﺳﻴﻦ‪(10iu‬‬ ‫ﻓﻴﺎﻹﻋﺪاداﺗﺄﻳﻨﺎﻷوﻛﺴﻴﺘﻮﺳﻴﻨﻴﻜﻮﻧﺎﻷﻣﻢ اﻟﻤﺘﺤﺪةﻣﺘﻮﻓﺮة(أو‬
‫ﻋﻠﯩﺎﻻ)‪im/iv‬‬ ‫ﺑﻬﻠﻠﺤﺼﻮل‬ ‫ﻳﻜﻮﻧﻤﻮﺻﻰ‬ ‫اﻻﺳﺘﻌﻤﺎﻟﻤﻦ‪eed)،‬دورﺗﻬﺎﻧﻮﻋﻴﺔ‪cannot‬ﻛﻦ‪guarant‬‬
‫ﻋﻠﯩﻜﻼﻟﻮﻻ‪ention‬ﻟﺴﺎﺑﻖ‬ ‫ﻣﻦ‪pph‬ﻟﻠﺤﺼﻮل‬ ‫أوﻟﻮ‪(carbetocin،‬أﺧﺮﯨﻌﻦ ﻃﺮﻳﻖ اﻟﺤﻘﻦ‪uterotonics‬‬
‫‪1‬دات‬ ‫ﻣﻮآﺧﺮون‪hylergome‬ت‪/،rine‬اﻟﻤﻨﺎﺳﺐ‪ergometrine‬‬
‫‪se‬ﻓﻌﻞ‪-‬أواﻷوﻛﺴﻴﺘﻮﺳﻴﻨﻮ‪ergometrine‬اﻟﺜﺎﺑﺘﺔ‬
‫ﻳﻜ ﻮ ن ‪oprostol‬أ وﻋ ﻦ ﻃ ﺮﻳ ﻖ اﻟ ﻔﻤﻨﻈ ﻢ اﻟﻤﻌﻠ ﻮ ﻣﺎت اﻹد ا رﻳ ﺔ )ﻣ ﺰﻳﺞ‬
‫‪1.2‬اﻟﺘﻮﺻﻴﺔ‬ ‫‪Fpph1‬ﻣﻮﺻﻰ ﺑﻬﻠﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻤﻨﻊ ‪o‬‬
‫‪carbetocin(100mcg،‬اﻻﺳﺘﻌﻤﺎﻟﻤﻦ‬
‫ﻳ ﻜ ﻮ ﻧ ﻤ ﻮ ﺻ ﻰ ﺑ ﻬ ﻠ ﻠ ﺤ ﺼ ﻮ ل ﻋ ﻠ ﯩ ﺎ ل )‪im / iv‬‬
‫ﻣﻨﻌﻤﻦ‪pph‬ﻟﻠﺤﺼﻮل ﻋﻠﯩﻜﻼﻟﻮﻻداﺗﻔﻲ‬
‫اﻟﺴﻴﺎﻗﺎﺗﺄﻳﻨﺪورﺗﻬﺎﻛﻠﻔﺔﻳﻜﻮﻧﻤﻤﺎﺛﻠﺔإﻟﯩﺄﺧﺮﯨﻔﻌﺎل‪uter‬‬
‫‪otonics1‬‬
‫اﻟﻌﺎﻟﻤﺼﺤﺔاﻟﻤﻨﻈﻤﺔ‪.‬ﻣﻦ اﻟﺬﯨﺎﻟﺘﻮﺻﻴﺎت‪.uterotonics‬ﻟﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺒﻌﺪ اﻟﻮﻻدةاﻟﻨﺰﻳﻒ‪1..2018.‬‬
‫‪carbetocin‬ﻋ ﺐ ء و ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪ │pph‬و ﺣ ﺪ ة‬

‫ﻳ ﻜ ﻮ ﻧ ﻮ ﺷ ﻤ ﻠ ﺘ ﻔ ﻴ ﺎ ﻟ ﻤ ﻦ ا ﻟ ﺬ ﯨ ﺎﻷ ﺳ ﺎ ﺳ ﻴ ﺔ اﻷ د و ﻳ ﺔ ﻗ ﺎ ﺋ ﻤ ﺔ ‪hsc‬‬

‫‪2019.‬ﺳﺎﻧﺖﻗﺎﺋﻤﺔ‪:21‬اﻟﻌﺎﻟﻤﺼﺤﺔﻣﻨﻈﻤﺔﻧﻤﻮذﺟﻘﺎﺋﻤﺔﻣﻨﺎﻷﺳﺎﺳﻴﺔاﻷدوﻳﺔ‪1.‬‬
‫‪carbetocin‬ﻋ ﺐ ء و ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪ │pph‬و ﺣ ﺪ ة‬

‫‪pph‬و ﻛ ﻼ ء ﻣ ﺴ ﺘ ﻌ ﻤ ﻠ ﺔ ﻓ ﻴ ﺎ ﻟ ﻤ ﻨ ﻌ ﻤ ﻦ ‪uterotonic‬‬

‫اﻟ ﻔ ﺼﻠﻤ ﻨﺎ ﻟﻤ ﺨﺪ ر ا ﺗﻤ ﺜ ﺎﻟ ﺘ ﻘ ﻨ ﻴ ﺔ ﻣ ﻨﻌ ﻤ ﻞ‬
‫‪1‬ﻳﺮﺑﻄﻔﻴﺎﻷوﻛﺴﻴﺘﻮﺳﻴﻨﻤﺴﺘﻘﺒﻼﺗﻮﻳﺤﻔﺰﻣﻴﻮﻣﻴﺘﺮﻳﺎﻟﻨﺎﻋﻤﻌﻀﻠﺔﺗﻘﻠﺼﺎت•‬
‫اﻷوﻛﺴﻴﺘﻮﺳﻴﻦ‬ ‫اﻷوﻛﺴﻴﺘﻮﺳﻴﻦ‬

‫ﻃﻮﻳﻞ اﻟﻤﻔﻌﻮل‬ ‫‪2‬ﻳﻜﻮﻧﻴﻌﺪ‪ctivity‬ﻟﻜﻨﻤﺪةﻣﻨﺎﻟﺮﺣﻤﺎ‪،‬ﻧﻔﺴﻤﺜﻼﻷوﻛﺴﻴﺘﻮﺳﻴﻦ•‬

‫اﻷ و ﻛ ﺴ ﻴ ﺘ ﻮ ﺳ ﻴ ﻨ ﺎ ﻟ ﺘ ﻨ ﺎ ﻇ ﺮ ﻳ ﺔ‬
‫‪carbetocin‬‬

‫‪2‬ﺑﺸﻜﻞ ﻣﻠﺤﻮﻇﺰﻳﺎدةﻧﺎﻋﻤﻌﻀﻠﺔﻧﺸﺎط•‬
‫اﻟﺸﻘﺮاﻧﻘﻠﻮﻳﺪات‬ ‫‪ergometrine‬‬ ‫ﻳﻨﺘﺞ ﻋﻨﻬﻤﻴﻮﻣﻴﺘﺮﻳﺎﻟﺘﻘﻠﺼﺎﺗﻌﻦ ﻃﺮﻳﻘﺎﻟﻜﺎﻟﺴﻴﻮﻣﻘﻨﺎةﺗﻘﻨﻴﺔو‪•-actin‬‬
‫‪2‬اﻟﻤﻴﻮﺳﻴﻨﺎﻟﺘﻔﺎﻋﻞ‬
‫* ‪syntometrine‬‬ ‫ﻣﻴﻮﻣﻴﺘﺮﻳﺎل ‪ained‬ﺟﺎﻣﻌﺔ اﻟﺴﻮدا ن ﻟﻠﻌﻠﻮم (ﻧ ﻔﺴﻤﺜﻞ ‪•ergometrine‬‬
‫اﻟﺸﻘﺮاﻧﻘﻠﻮﻳﺪاﺗﻮاﻷ‬
‫وﻛﺴﻴﺘﻮﺳﻴﻦ‬ ‫‪(500mcgergometrine+5‬‬ ‫‪3‬ﺗ ﻘﻠ ﺼﺎت )واﻷ وﻛﺴﻴ ﺘ ﻮ ﺳﻴ ﻦ (اﻟﺴ ﺮﻳﻌﺒﺪ اﻳ ﺔ ﻣﻨﺎﻟﻌﻤﻞ )‬
‫)اﻷوﻛﺴﻴﺘﻮﺳﻴﻦ‪iu‬‬
‫‪4‬ﻣﺘﻮرﻃﻔﻴﻌﻨﻖ اﻟﺮﺣﻤﺎﻟﻨﺎﺿﺠﺔ•‬
‫اﻟﺒﺮوﺳﺘﺎﺟﻼﻧﺪﻳﻦ‬ ‫ا ﻟﻤﻴ ﺰ و ﺑ ﺮ و ﺳﺘ ﻮ ل‬ ‫ﻳﺰﻳﺪﻣﻴﻮﻣﻴﺘﺮﻳﺎﻟﺘﻘﻠﺼﺎﺗﻌﻦ ﻃﺮﻳﻘﻌﻨﻖ اﻟﺮﺣﻤﻨﺎﻋﻤﻌﻀﻠﺔاﺳﺘﺮﺧﺎءوﻓﻲ •‬
‫‪2‬ازدﻳﺎداﻟﺨﻼﻳﺎاﻟﻜﺎﻟﺴﻴﻮم‬
‫‪،‬س‪* 3،51.arrowsmith‬ﺑﻄﻼﻧﻔﻴﺤﺎﻻﺗﻤﻨﺸﺪﻳﺪةارﺗﻔﺎع ﺿﻐﻂ اﻟﺪم‪،‬ﻗﺒﻞ اﻹرﺟﺎج ﺗﺸﻨﺞ‪،‬واﻹرﺟﺎج ﺗﺸﻨﺞ‬ ‫‪.2019.‬ﻣﻠﺨﺼﻤﻨﺎﻟﻤﻨﺘﺠﺨﺼﺎﺋﺺ‪.syntometrine‬اﻟﺘﺤﺎﻟﻔﺎﻷدوﻳﺔ‪3.‬‬
‫‪2014‬؛‪.jneuroendocrinol369.- 356: 26‬ورﻳﺲ‬ ‫‪2002‬؛‪.jreprodimmunol224.- 217: 57‬ﻛﻴﻠﻲ‪4.rw‬‬
‫إدارةواﻟﺠﺮاﺣﻴﺔاﻟﺘﺪﺧﻞ‪2006‬؛‪.113.- 98‬م‪2.prendivillew،o 'connell‬‬ ‫اﻟﻤﻌﻬﺪ اﻟﻮﻃﻨﻲ ﻟﻺﺣﺼﺎء‪،‬ﺣﻘﻨﺔﻣﻠﺨﺼﻤﻨﺎﻟﻤﻨﺘﺠﺨﺼﺎﺋﺺ ‪.ergometr.2018.‬ﻓﺎر ﻣﺎ اﻟﻤ ﺤﺪودة ‪5.hameln‬‬
‫‪carbetocin‬ﻋ ﺐ ء و ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪ │pph‬و ﺣ ﺪ ة‬

‫‪carbetocin‬ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪-‬ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻨ ﺎ ﻟ ﺤ ﺮ ا ر ة‬

‫ﻳﻜﻮﻧﻴﻤﻜﻦ اﻻﻋﺘﻤﺎد ﻋﻠﻴﻬﺎ‪،‬ﻃﻮﻳﻼ‪3 0 ° c ) .hsc‬ﻓﻲ (أﺷﻬﺮ ‪4 8‬ﻫﻠﻠﻴﺴﻴﺘﻄﻠﺒﺘﺒﺮﻳﺪوﻳﻤﻜﻨﻜﻨﻤﺨﺰﻧﻠﻠﺤﺼﻮل ﻋﻠﯩﻔﻮﻗﺈﻟﻰ‪. hsc‬‬

‫ﻟﻌﻤ ﻞ‪ ،‬ﻓﻌﺎﻟﻤﺜ ﻼ و ﺣﻴﺪ اﻟ ﺠﺮﻋ ﺔ‪ ،‬و ﺳﻬ ﻺﻟﯩﺈد ارةﻟﻠ ﺤ ﺼ ﻮ ل ﻋﻠﯩﺎ ل‬
‫ﻣﻨﻌﻤ ﻦ * ‪pph‬‬

‫‪:‬ﻳﻜﻮﻧﺄﺟﺮﻳﺘﻔﻲ‪2018‬ﺑﻮاﺳﻄﺔ‪،gallos‬وآﺧﺮونﷲ‪-analys‬ﺑﺎﻟﻨﺴﺒﺔ اﻟﯩﺈﻟﯩﺎﺷﺒﻜﺔاﻟﺘﻌﺮﻳﻒ‪.‬‬
‫ﻟﻠﺤﺮارة ﻣﺴﺘﻘﺮة)‪carbetocin(hsc‬ﻳﻜﻮﻧﺎﻷﻋﻠﻰ ﻣﺮﺗﺒﺔوﺣﻴﺪ‪uterotonic‬وﻛﻴﻠﻠﻠﺤﺼﻮل ‪.‬‬
‫‪1‬ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺪﻣﺨﺴﺎرة‪≥500ml‬‬
‫‪uterotonics1‬ﻣﺎﻳﻮأﻳﻀﺎﺗﻘﻠﻴﻼﻻﺳﺘﻌﻤﺎﻟﻤﻨﺈﺿﺎﻓﻲ‪. hsc‬‬
‫* ‪1‬إﻟﯩﻴﻤﻨﻊ‪uterotonicspph‬واﻷوﻛﺴﻴﺘﻮﺳﻴﻨﻴﻤﻠﻜﺎﻟﻤﻌﻈﻤﻤﻼﺋﻤﺠﺎﻧﺒﺘﺄﺛﻴﺮاﻟﻤﻠﻒ اﻟﺸﺨﺼﻴﻤﻦ ﺑﻴﻦ‪.hsc‬‬

‫‪.‬ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻜﻮﻧﺄﺷﺎرﺗﻠﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺎﻟﺮﺣﻤﺎﻟﻨﺰﻓﻨﻈﺮاإﻟﯩﺒﻌﺪ اﻟﻮﻻدةاﻟﺮﺣﻤﻐﻴﺮ ﻣﺸﺪد‪-‬اﻟﺤﺮارة*‬

‫‪011689.‬اﻟﻘﺮص اﻟﻤﻀﻐﻮط ‪(4):‬ﻛﻮﻛﺮﻳﻨﻘﺎﻋﺪة ﺑﻴﺎﻧﺎت‪syst‬ﻣﺮاﺟﻌﺔ ‪.(2018).‬وآﺧﺮونﷲ‪1.gallos،‬‬
‫ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻹﻋﻼﻧ ﺈ ﺳ ﻌ ﺎ ﻓ ﻤ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪│carbetocin‬و ﺣ ﺪ ة‬

‫ﻣ ﻘ ﺎ ر ﻧ ﺔ ﻣ ﻦ ‪carbetocin‬واﻷ و ﻛ ﺴ ﻴ ﺘ ﻮ ﺳ ﻴ ﻦ‬

‫ﻣﺪةﻣﻨﻌﻤﻞ‬

‫ﺗﻤﺘﺎﻳﻌﺪﻧﺼﻒ اﻟﺤﻴﺎةوﻣﺪةﻣﻦ‪carbetocin‬‬
‫ﻋﻤﻠﻤﻨﺎﻷوﻛﺴﻴﺘﻮﺳﻴﻨﻨﻈﺮاإﻟﯩﻌﻠﯩﺰﻳﺎدة‪biologi‬ﻛﺎل‬ ‫ﻟﻨﺎ‪1-2h‬‬
‫‪tocin‬ﺣﻴﺎةﻓﻴﺎﻟﺒﻼزﻣﺎوﺗﺄﺛﻴﺮﻋﻠﯩﺎﻷوﻛﺴﻲ‪-‬ﻧﺼﻒ‬
‫‪1‬ﻣﺴﺘﻘﺒﻼت‬

‫‪ately‬اﻟﺮﺣﻤﺘﻘﻠﺼﺎﺗﺂﺧﺮ‪approxim‬‬
‫ﻣﻦ‪carbetocin‬ﻣﺮةﻳﻌﺪﻣﻊ‪-‬أرﺑﻌﺔ‬
‫‪1،2‬ﻣﻌﺎﻷوﻛﺴﻴﺘﻮﺳﻴﻦ‬

‫‪.1961‬؛)‪2.embreymp.brmedj1738- 1737: 1 (5241‬ذر ‪.1992‬؛)‪67- 60: 52 (1‬؛‪.clinpharmacol‬وآﺧﺮونﷲ‪،‬ﻫﻨﺘﺮ‪1.dj‬‬

‫‪carbetocin‬ﻋ ﺐ ء و ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪ │pph‬و ﺣ ﺪ ة‬

‫‪1‬ا ﻟ ﻤ ﻠ ﻒ ا ﻟ ﺸ ﺨ ﺼ ﻲ ‪ety‬ﺗ ﻤ ﺘ ﺎ ﻣ ﻼ ﺋ ﻤ ﺎ ﻟ ﻘ ﻮ ا ت ا ﻟ ﻤ ﺴ ﻠ ﺤ ﺔ ا ﻟ ﺴ ﻮ د ا ﻧ ﻴ ﺔ ‪hsc‬‬

‫ﻟﻜﻼﻻﻟﺘﺤﻠﻴﻞ اﻟﺘﻠﻮي‪،‬ﻟﻠﺤﺮارة ﻣﺴﺘﻘﺮة‪carbetocin‬واﻷوﻛﺴﻴﺘﻮﺳﻴﻦ‬

‫ﻳ ﻤ ﻠ ﻜ ﺎ ﻟ ﻤ ﻌ ﻈ ﻤ ﻤ ﻼ ﺋ ﻤ ﺠ ﺎ ﻧ ﺒ ﺘ ﺄ ﺛ ﻴ ﺮ ا ﻟ ﻤﻠ ﻒ ا ﻟ ﺸ ﺨ ﺼ ﻴ ﻤ ﻦ ﺑ ﻴ ﻦ‬
‫* ‪pph‬إﻟﯩﻴﻤﻨﻊ‪uterotonics‬‬
‫ﻣﺴﺘﻘﺮة‪carbetocin‬واﻷوﻛﺴﻴﺘﻮﺳﻴﻨﻴﻤﻠﻜﺎﻣﻤﺎﺛﻠﺔاﻟﺴﻼﻣﺔاﻟﻤﻠﻒ اﻟﺸﺨﺼﻲ‪-‬اﻟﺤﺮارة‪.‬‬
‫ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻜﻮﻧﺎﻟﻔﻘﻂ‪uterotonic‬ﻣﻤﺎﺛﻠﺔإﻟﯩﺎﻷوﻛﺴﻴﺘﻮﺳﻴﻨﻔﻲ ﺟﻤﻴﻊ ‪-‬اﻟﺤﺮارة‪.‬‬
‫ﻣﻦ ﺿﻤﻨﻬﺎﺣﻤﻰ‪،‬اﻟﻐﺜﻴﺎن‪،‬ﻳﺮﺗﺠﻔﻮاﻟﺘﻘﻴﺆ‪1‬أﻧﺤﺎءﻛﻠﺠﺎﻧﺒﺘﺄﺛﻴﺮاﺗﺘﻘﻴﻴﻤﻔﻴﺎﻟﺸﺒﻜﺔاﻟﺘﺤﻠﻴﻞ اﻟﺘﻠﻮي‬

‫‪.‬ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻜﻮﻧﺄﺷﺎرﺗﻠﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺎﻟﺮﺣﻤﺎﻟﻨﺰﻓﻨﻈﺮاإﻟﯩﺒﻌﺪ اﻟﻮﻻدةاﻟﺮﺣﻤﻐﻴﺮ ﻣﺸﺪد‪-‬اﻟﺤﺮارة*‬

‫‪011689.‬اﻟﻘﺮص اﻟﻤﻀﻐﻮط ‪(4):‬ﻛﻮﻛﺮﻳﻨﻘﺎﻋﺪة ﺑﻴﺎﻧﺎت‪syst‬ﻣﺮاﺟﻌﺔ ‪.(2018).‬وآﺧﺮونﷲ‪1.gallos،‬‬
‫‪carbetocin‬ﻋ ﺐ ء و ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪ │pph‬و ﺣ ﺪ ة‬

‫ﻟ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪carbetocin‬ﻳ ﻜ ﻮ ﻧ ﻄ ﻮ ﻳ ﻞ ا ﻟ ﻤ ﻔ ﻌ ﻮ ﻟ ﻮ ﻓ ﻌ ﺎ ل‬
‫ﻟ ﻠ ﺤ ﺼ ﻮ ل ﻋ ﻠ ﯩ ﺎ ﻟ ﻤ ﻨ ﻌ ﻤ ﻦ * ‪pph‬‬

‫ﻣﺴﺘ ﻘﺮة ‪carbetocin‬ﺗﻤﺘﺴﺮﻳ ﻊ ‪onse‬ﺗﻤﻨﻌﻤﻞ (ﺿﻤﻦ ‪2‬دﻗﻴ ﻘﺔﻟﻠ ﺤﺼﻮ ل ﻋﻠﯩﻜﻼﻫﻤﺎ ‪iv‬و‪-im‬اﻟ ﺤﺮ ارة ‪.‬‬
‫اﻟﺤﺪ اﻷ‪119‬اﻟﺤﺪ اﻷدﻧﯩﻠﻠﺤﺼﻮل ﻋﻠﯩﺎوﺣﻴﺪ ‪ivinjec‬ﻧﺸﻮﺋﻬﺎ‪(60،‬وﻟﻔﺘﺮات ﻃﻮﻳﻠﺔﻣﺪةﻣﻨﻌﻤﻞ ‪،‬ﺣﻴﺎة ‪-‬ﻃﻮﻳﻠﻨﺼﻒ ‪)،‬اﻻدارة‬
‫‪) 1،2‬دﻧﯩﻠﻠﺤﺼﻮل ﻋﻠﯩﻌﻠﻰ‪im‬ﺣﻘﻨﺔ‬
‫‪1‬ﺣﻘﻨﺔ‪im / iv‬ﻧﺰﻳﻔﺎﻟﺘﺎﻟﻴﺎوﺣﻴﺪ‪ssive‬ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻤﻜﻨﺘﻘﻠﻴﻼﻟﺨﻄﺮﻣﻨﺎﻟﺮﺣﻤﻐﻴﺮ ﻣﺸﺪدو‪-exce‬اﻟﺤﺮارة‪.‬‬
‫‪3-5‬ﺣﻘﻨﺄوﺿﺦ‪lusiv‬اﻷوﻛﺴﻴﺘﻮﺳﻴﻨﻔﻲ ﻛﺜﻴﺮ ﻣﻦ اﻷﺣﻴﺎﻧﻴﺘﻄﻠﺒﺒﻄﻲءﺑﻮ‪.‬‬
‫ﻣﻦ اﻟﻤﺤﺘﻤﻠﺼﻨﻌﻔﺈﻧﻬﺒﺴﻴﻄﺔوﻣﺮﻳﺤﺔإﻟﯩﺈدارة‪،1‬ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻜﻮﻧﻤﻮﺛﻮﻗﻤﺜﻼوﺣﻴﺪﻣﻌﻴﺎراﻟﺠﺮﻋﺔ‪-‬اﻟﺤﺮارة‪.‬‬

‫‪.‬ﻟﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺎﻟﺮﺣﻤﺎﻟﻨﺰﻓﻨﻈﺮاإﻟﯩﺒﻌﺪ اﻟﻮﻻدةاﻟﺮﺣﻤﻐﻴﺮ ﻣﺸﺪد‪ated‬ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻜﻮﻧﺎﻟﻬﻨﺪﻳﺔ‪-‬اﻟﺤﺮارة*‬

‫اﻟﻌﻀﻠﻲ‪im:‬داﺧﻞ اﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ؛‪iv:‬‬
‫‪2021).‬آﺧﺮاﻟﻮﺻﻮﻟﻴﻮﻟﻴﻮ(أون=‪/‬؟ﻻﻧﻎ‪.swissmedicinfo.ch‬ﺷﺒﻜﺔ اﻻﺗﺼﺎﻻت اﻟﻌﺎﻟﻤﻴﺔ‪https: //‬ﻣﻠﺨﺼﻤﻨﺎﻟﻤﻨﺘﺠﺨﺼﺎﺋﺺ‪1.carbetocinferring‬‬
‫‪2).clinpharmacolther52 (1)60-67.‬ﻫﻨﺘﺮ‪،‬د‪.‬ﻳﺎء‪،‬ب‪.‬ﺷﻮﻟﺰودﺑﻠﻴﻮ‪.‬ﻓﺎﺳﻨﺎر‪2..(199‬‬
‫‪(4):cd011689.‬ﻛﻮﻛﺮﻳﻨﺎﻟﺒﻴﺎﻧﺎﺗﻘﺎﻋﺪة‪syst‬ﻣﺮاﺟﻌﺔ‪،.(2018).‬أوﻻ‪:‬د‪،.‬وآﺧﺮونﷲ‪3.gallos‬‬
‫‪13(9):e0203810.‬واﺣﺪ‪plos‬اﻟﻜﺒﺪ‪،‬ﺧﺎﻣﺴﺎ‪:‬إل‪،‬وآﺧﺮونﷲ‪4.o.(2018).‬‬
‫‪8(4):e62810.‬واﺣﺪ‪.(2013). plos‬دﻳﺒﺎك‪،‬ن‪.‬ن‪ ،‬وآﺧﺮونﷲ‪5.‬‬
‫‪carbetocin‬ﻋ ﺐ ء و ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪ │pph‬و ﺣ ﺪ ة‬

‫ﻟ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪carbetocin‬ﻳ ﻜ ﻮ ﻧ ﻄ ﻮ ﻳ ﻞ ا ﻟ ﻤ ﻔ ﻌ ﻮ ﻟ ﻮ ﻓ ﻌ ﺎ ل‬
‫ﻟ ﻠ ﺤ ﺼ ﻮ ل ﻋ ﻠ ﯩ ﺎ ﻟ ﻤ ﻨ ﻌ ﻤ ﻦ * ‪pph‬‬

‫و ﻗ ﺘ ﻤ ﻨ ﺤ ﻨ ﻴ ﺎ ت ‪ -‬ﺗ ﺮﻛ ﻴ ﺰ‬
‫اﻷوﻛﺴﻴﺘﻮﺳﻴﻦ)‪(10iuim‬‬ ‫)‪carbetocin(100μgim‬‬
‫‪1200‬‬

‫ﻟﻠﺤﺼﻮل ﻋﻠﻰ‪im‬وﺣﻴﺪﺟﺮﻋﺎﺗﻤﻦ‬ ‫‪1000‬‬

‫وﺑﺸﻜﻞ ﺻﺤﻴﺤﻤﺨﺰناﻷ‪hsc‬‬ ‫‪800‬‬

‫**‪1،2‬وﻛﺴﻴﺘﻮﺳﻴﻦ‬

‫)‪(pg/ml‬اﻟﺒﻼزﻣﺎاﻟﻤﺨﺪراﺗﺘﺮﻛﻴﺰ‬
‫‪600‬‬

‫‪400‬‬

‫‪200‬‬

‫‪0‬‬
‫‪050100150200250300350‬‬

‫و ﻗ ﺖ (د ﻗ ﻴ ﻘ ﺔ )‬

‫‪.‬ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻜﻮﻧﺄﺷﺎرﺗﻠﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺎﻟﺮﺣﻤﺎﻟﻨﺰﻓﻨﻈﺮاإﻟﯩﺒﻌﺪ اﻟﻮﻻدةاﻟﺮﺣﻤﻐﻴﺮ ﻣﺸﺪد‪-‬اﻟﺤﺮارة*‬

‫‪).‬ﻟﻠﺤﺼﻮل ﻋﻠﯩﺎﻷوﻛﺴﻴﺘﻮﺳﻴﻦ]‪hsc،10iu[17μg /ml‬ﻟﻠﺤﺼﻮل ﻋﻠﻰ‪(100μg /ml‬ﻳﺴﺘﻨﺪﻋﻠﯩﺎوﺣﻴﺪ‪im‬اﻟﺠﺮﻋﺔ‪** ،‬ﻓﻴﻐﻴﺮ اﻟﺤﻮاﻣﻠﻨﺴﺎء‬
‫اﻟﻌﻀﻠﻲ‪im:‬‬
‫‪، 2 0 1 7 ) .‬ﺗﺠﺎرﻳﻔﻴﺎﻟﺜﻘﺔ ﺑﺎﻟﻨﻔﺲ (اﻟﻤﺤﻄﺔ اﻟﻤﺬﻛﻮرةدراﺳﺔ ﻋﻦ ﻣﻮﺿﻮع واﺣﺪ‪1 . pabal‬‬
‫‪/10.1016/j.ebiom.2017.07.020.‬اﻟﻤﺆﺳﺴﺔ ‪.‬دوي ‪: //‬اﻟﻤﺘﺸﻌﺐ ‪:‬ﻣﺘﻮﻓﺮةﻓﻲ ‪.( 2017).ebiomedicine،22،249-255.‬ﻓﺮﻧﺎﻧﺪو‪،‬د ا ل ‪ ،‬وآﺧﺮونﷲ ‪2 .‬‬
‫‪hsc‬ﻋ ﺐ ء و ا ﻟ ﺴ ﺮ ﻳ ﺮ ﻳ ﺔ ﻗ ﻴ ﻤ ﺔ ﻣ ﻦ ‪ │pph‬و ﺣ ﺪ ة‬

‫ﻟ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪carbetocin‬ﻳ ﻜ ﻮ ﻧ ﻄ ﻮ ﻳ ﻞ ا ﻟ ﻤ ﻔ ﻌ ﻮ ﻟ ﻮ ﻓ ﻌ ﺎ ل‬
‫ﻟ ﻠ ﺤ ﺼ ﻮ ل ﻋ ﻠ ﯩ ﺎ ﻟ ﻤ ﻨ ﻌ ﻤ ﻦ * ‪pph‬‬

‫ﻣ ﺪ ة ﻣ ﻨ ﺘ ﺄ ﺛ ﻴ ﺮ ﻟﻠ ﺤ ﺼ ﻮ ل‬
‫واﻷ‪hsc‬ﺣﻘﻨﺔﻣﻦ‪im‬ﻋﻠﻰ‬
‫**‪1،2‬وﻛﺴﻴﺘﻮﺳﻴﻦ‬ ‫)‪carbetocin(100μgim‬‬ ‫‪119‬دﻗﻴﻘﺔ‬

‫اﻷوﻛﺴﻴﺘﻮﺳﻴﻦ)‪(10iuim‬‬ ‫‪30‬دﻗﻴﻘﺔ‬

‫‪020406080100120‬‬

‫ﻗﺴﻢ اﻟﺘﺪرﻳﺐ واﻻﻣﺘﺤﺎﻧﺎت)‪(minu‬ﻣﺪةﻣﻨﺘﺄﺛﻴﺮ‬

‫‪.‬ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻜﻮﻧﺄﺷﺎرﺗﻠﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺎﻟﺮﺣﻤﺎﻟﻨﺰﻓﻨﻈﺮاإﻟﯩﺒﻌﺪ اﻟﻮﻻدةاﻟﺮﺣﻤﻐﻴﺮ ﻣﺸﺪد‪-‬اﻟﺤﺮارة*‬

‫‪.‬ﻳﺴﺘﻨﺪﻋﻠﯩﺎوﺣﻴﺪ‪im‬اﻟﺠﺮﻋﺔ **‬
‫اﻟﻌﻀﻠﻲ‪im:‬‬
‫‪52 (1)60-67.‬ذر‪.clinpharmacol‬اﻟﺘﻤﺜﻴﻼﻷوﻛﺴﻴﺘﻮﺳﻴﻨﺎﻟﺘﻨﺎﻇﺮﻳﺔﻋﻠﯩﺎﻟﺒﻌﺪ اﻟﻮﻻدةاﻟﺮﺣﻢ ‪-‬اﻃﻮﻳﻞ ‪،‬ﺗﺄﺛﻴﺮﻣﻦ‪.(1992).carbetocin‬ﻓﺎﺳﻨﺎر ‪.‬ﻫﻨﺘﺮ‪،‬د ‪.‬ﻳ ﺎ ء ‪،‬ب ‪.‬ﺷﻮﻟﺰو‪1. w‬‬
‫‪.brmedj1 ( 5241)1737-1738.‬ا‪tocographic‬دراﺳﺔ ‪،:‬م ‪.‬ب ‪.( 1961) .‬ﻣﺘﺰاﻣﻨﺔاﻟﻌﻀﻠﻴﺤﻘﻨﺔﻣﻨﺎﻷوﻛﺴﻴﺘﻮﺳﻴﻨﻮ‪2 . embreyergometrine‬‬
‫و ﺣ ﺪ ة ‪2‬ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻻ د ا ر ة‬
‫ﻣ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪carbetocin‬ﻟ ﻠ ﺤ ﺼ ﻮ ل ﻋ ﻠ ﯩ ﺎ ل‬
‫ﻣ ﻨ ﻌ ﻤ ﻦ * ‪pph‬‬

‫ﻟﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺎﻟﺮﺣﻤﺎﻟﻨﺰف ‪ated‬ﻣﺴ ﺘ ﻘﺮة ‪carbetocin‬ﻳ ﻜ ﻮﻧﺎﻟﻬﻨﺪﻳﺔ ‪-‬اﻟ ﺤﺮارة *‬

‫ﻧﻈﺮا إﻟﯩﺒﻌﺪ اﻟﻮﻻدة اﻟﺮﺣﻤﻐﻴﺮ ﻣﺸﺪد ‪.‬‬
‫ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻹﻋﻼﻧ ﺈ ﺳ ﻌ ﺎ ﻓ ﻤ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪│carbetocin‬و ﺣ ﺪ ة‬

‫أ ﺳ ﺒ ﺎ ﺑ ﻤ ﻦ ‪pph‬‬

‫‪1‬إﻋﺎدةاﻷﻋﻀﺎءال ‪4t‬ل‪:‬ﻣﻌﻈﻤﻤﺸﺘﺮﻛﺄﺳﺒﺎﺑﻠﻠﺤﺼﻮل ﻋﻠﻰ‪pph‬‬

‫ت‬ ‫ت‬ ‫ت‬ ‫ت‬

‫ﻟﻬﺠﺔ‬ ‫اﻟﺼﺪﻣﺔ‬ ‫اﻷ ﻧ ﺴ ﺠ ﺔ‬ ‫اﻟﺜﺮوﻣﺒﻴﻦ‬
‫اﻷﻣﻬﺎﺗﻨﺰﻳﻔﺎﺿﻄﺮاﺑﺎت‬
‫اﻟﺮﺣﻤﻐﻴﺮ ﻣﺸﺪداﻷﻋﻀﺎء اﻟﺘﻨﺎﺳﻠﻴﺔاﻟﻤﺴﺎﻟﻜﺎﻟﺼﺪﻣﺔاﻻﺣﺘﻔﺎﻇﺎﻟﻤﺸﻴﻤﺔ‬

‫‪1٪‬‬
‫‪70٪‬‬ ‫‪20٪‬‬ ‫‪1 0٪‬‬

‫‪jobstetgynaecol.124: e106-ee49.‬اﻟﺒﺎﺣﺚ‪.(2016).bjog‬وآﺧﺮونﷲ‪1.mavrides‬‬
‫ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻹﻋﻼﻧ ﺈ ﺳ ﻌ ﺎ ﻓ ﻤ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪│carbetocin‬و ﺣ ﺪ ة‬

‫ﺧ ﻄ ﺮ ا ﻟ ﻌ ﻮ ا ﻣ ﻠ ﻠ ﻠ ﺤ ﺼ ﻮ ل ﻋ ﻠ ﻰ ‪pph‬‬

‫ﺑﻌﺾ‪condit‬أﻳﻮﻧﺎﺗﻬﻼ‪،‬ﻋﻠﯽ رﻏﻤﺎﻷﻏﻠﺒﻴﺔﻣﻨﻨﺴﺎءﻣﻊ‪pph‬ﻳﻤﻠﻜﻼاﻟﺘﻌﺮﻓﺨﻄﺮﻋﺎﻣﻞ‬
‫ﻟﻤﺮﺗﺒﻄﺔﻣﻌﻌﻠﯩﺰﻳﺎدة‬
‫‪1،2‬ﺟﻴﺒﻌﺪ‪ ،‬ﺑﻌﺪﻣﺎوﻻدة ‪k o F bl eed‬س‪ri‬‬
‫اﻟﺘﻜﺎﻓﺆأﻧﺎ‪ult‬م ‪g rand‬‬ ‫)اﻟﺮﺣﻤﺎﻧﺘﻔﺎخ(ﻋﻠﻰ ﺳﺒﻴﻞ اﻟﻤﺜﺎﻟﻌﺪةاﻟﺤﻤﻞ‪.‬‬
‫ﻟﻔﺘﺮات ﻃﻮﻳﻠﺔﻋﻤﻞ‪.‬‬ ‫ﺑﺪا ﻧﺔ ‪.‬‬
‫ﻗﺒﻠﺘﺎرﻳﺨﻤﻦ‪.pph‬‬ ‫ﺗ ﺠﻠ ﻂ ا ﻟ ﺪ ﻣ ﺎ ﺿ ﻄ ﺮ ا ﺑ ﺎ ت ‪.‬‬
‫ﻗﻴﺎدةإﻟﯩﺎﻟﺤﺴﺎﺳﻴﺔﻣﻨﺎﻷ‪،‬ﻟﻔﺘﺮات ﻃﻮﻳﻠﺔاﻻدارةﻣﻨﺎﻷوﻛﺴﻴﺘﻮﺳﻴﻦ‪.‬‬ ‫ﺗ ﺴﻤ ﻢ اﻟ ﺤ ﻤ ﻞ ‪.‬‬
‫)‪(otrs‬وﻛﺴﻴﺘﻮﺳﻴﻨﻤﺴﺘﻘﺒﻼت‬
‫ﺧﺼﻮﺻﺎ ‪،‬وﻻدة ﻗﻴﺼﺮﻳﺔاﻟﻮﻻدة ‪.‬‬
‫‪،‬اﻻدارةﻣﻨﺎﻟﻤﺨﺪراﺗﻤﻦ ﻫﺬا اﻟﻘﺒﻴﻠﻤﺜﻞ‪halogenat‬إدﻣﺨﺪروﻛﻼء‪.‬‬ ‫ﺑﻌﺪ‪ ،‬ﺑﻌﺪﻣﺎﻟﻔﺘﺮات ﻃﻮﻳﻠﺔﻋﻤﻞ‬
‫‪،‬ﻣﻜﺎﻓﺤﺔاﻟﺘﻬﺎﺑﺎﻟﻤﺨﺪرات‪،nonsteroidal‬اﻟﻨﺘﺮات‬
‫‪،‬ﻛﺒﺮﻳﺘﺎت‪sium‬ﻣﺎﻏﻨﻲ‬
‫اﻟﻨﺰف‪.antepartum‬‬
‫ﺑﻴﺘﺎ‪، sympathomimetics‬وﻧﻴﻔﻴﺪﻳﺒﻴﻦ‬
‫‪1‬ﻋﺎﻣﻞ‪ravating‬ﻓﻘﺮ دﻣﻴﻜﻮﻧﺎﻣﺸﺘﺮك‪،agg‬ﻋﻼوة ﻋﻠﻰ ذﻟﻚ‬
‫‪:‬ﻣﺘﻮﻓﺮةﻓﻲ ‪،2018.‬ﻟﻠﺤ ﺼﻮ ل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺒﻌﺪ اﻟﻮﻻدةاﻟﻨﺰ ف ‪:uterotonics‬ﻣ ﻦ اﻟﺬ ﯨﺎﻟﺘ ﻮﺻﻴﺎت ‪.‬اﻟﻌﺎﻟﻤ ﺼﺤﺔ ﻣﻨﻈﻤ ﺔ ‪1.‬‬
‫)؛‪2021‬ﺷﻬﺮ ﺳﺒﺘﻤﺒﺮ ‪:‬آﺧﺮاﻟﻮﺻﻮل (‪ua= 1 &ua= 1‬ﻗﻮات اﻟﺪﻓﺎع اﻟﺸﻌﺒﻲ؟ ‪.‬اﻟﻤﻬﻨﺪس ‪/ 10665/277276/9789241550420-‬ﻣﻘﺒﺾ ‪/Bitstream/‬اﻟﻘﺰﺣﻴﺔ ‪/‬اﻟﺒﺎﺣﺚ ‪.‬ﻣﻦ اﻟﺬى ‪.‬ﺗﻄﺒﻴﻘﺎت ‪https: //‬‬
‫؛‪.bjog2016 e106-e149. : 124‬و آ ﺧ ﺮ و ن ﷲ ‪.‬ﻣ ﻨ ﻌ ﻮ إ د ا ر ة ﻣ ﻨ ﺒ ﻌ ﺪ ا ﻟ ﻮ ﻻ د ة ا ﻟ ﻨ ﺰ ﻳ ﻒ ‪،chandraharane،‬س ‪2.mavridese،allard‬‬
‫ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻹﻋﻼﻧ ﺈ ﺳ ﻌ ﺎ ﻓ ﻤ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪│carbetocin‬و ﺣ ﺪ ة‬

‫ﻣ ﻘ ﺎ ر ﻧ ﺔ ﻣ ﻦ ‪carbetocin‬واﻷ و ﻛ ﺴ ﻴ ﺘ ﻮ ﺳ ﻴ ﻦ‬

‫ﻣﺪةﻣﻨﻌﻤﻞ‬

‫ﺗﻤﺘﺎﻳﻌﺪﻧﺼﻒ اﻟﺤﻴﺎةوﻣﺪةﻣﻦ‪carbetocin‬‬
‫ﻋﻤﻠﻤﻨﺎﻷوﻛﺴﻴﺘﻮﺳﻴﻨﻨﻈﺮاإﻟﯩﻌﻠﯩﺰﻳﺎدة‪biologi‬ﻛﺎل‬ ‫ﻟﻨﺎ‪1-2h‬‬
‫‪tocin‬ﺣﻴﺎةﻓﻴﺎﻟﺒﻼزﻣﺎوﺗﺄﺛﻴﺮﻋﻠﯩﺎﻷوﻛﺴﻲ‪-‬ﻧﺼﻒ‬
‫‪1‬ﻣﺴﺘﻘﺒﻼت‬

‫‪ately‬اﻟﺮﺣﻤﺘﻘﻠﺼﺎﺗﺂﺧﺮ‪approxim‬‬
‫ﻣﻦ‪carbetocin‬ﻣﺮةﻳﻌﺪﻣﻊ‪-‬أرﺑﻌﺔ‬
‫‪1،2‬ﻣﻌﺎﻷوﻛﺴﻴﺘﻮﺳﻴﻦ‬

‫‪.1961‬؛)‪2.embreymp.brmedj1738- 1737: 1 (5241‬ذر ‪.1992‬؛)‪67- 60: 52 (1‬؛‪.clinpharmacol‬وآﺧﺮونﷲ‪،‬ﻫﻨﺘﺮ‪1.dj‬‬

‫ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻹﻋﻼﻧ ﺈ ﺳ ﻌ ﺎ ﻓ ﻤ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪│carbetocin‬و ﺣ ﺪ ة‬

‫ﻟ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪carbetocin‬دﻻ ﻟ ﺔ‬

‫ﻟﻠﺤﺮارة ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻜﻮن‬
‫و ا ﻓ ﻘﻠﻠ ﺤ ﺼ ﻮ ل ﻋﻠ ﯩﺎﻟ ﻤ ﻨ ﻊ‬
‫ﻣ ﻨ ﺎﻟ ﺮ ﺣﻤ ﺎﻟ ﻨ ﺰ ﻓ ﻨ ﻈ ﺮ ا‬
‫* ‪ 1‬إ ﻟ ﯩ ﺒﻌ ﺪ ا ﻟ ﻮ ﻻ دة ا ﻟ ﺮ ﺣﻤ ﻐ ﻴ ﺮ ﻣ ﺸﺪ د‬

‫ﻳﺠﺐ أﻧﻜﻦ‪n‬ﻣﺴﺘﻘﺮة‪-carbetoci‬اﻟﺤﺮارة‪.‬‬
‫ﺗﺪارﻓﻘﻄﺒﻌﺪ‪ ،‬ﺑﻌﺪﻣﺎاﻟﺨﺪﻣﻪ ﺗﻮﺻﻴﻞ‬
‫‪1،2‬ﻣﻨﺎﻟﻄﻔﻞ رﺿﻴﻊ‬

‫اﻟﺘﺴﺠﻴﻺﻟﯩﺒﻌﺾ ‪lmic‬ﺳﻼ ﻳﺰاﻻﻟﺠﺎرﻳﺔ ‪..‬ﻣﺴﺘﻘﺮة ‪carbetocin‬ﻳﻜﻮ ﻧﻠﻴﺴﻮ اﻓﻘﻠﻠﺤﺼ ﻮ ل ﻋﻠﯩﺎﺳﺘﻌﻤﺎﻟﻔﻴ ﻜﻼﻟﻮﻻﻳﺎت اﻟﻘﻀﺎ ﺋﻴﺔ ‪-‬اﻟﺤﺮ ارة *‬
‫‪2021).‬آﺧﺮاﻟﻮﺻﻮﻟﻴﻮﻟﻴﻮ(أون=‪/‬؟ﻻﻧﻎ‪.swissmedicinfo.ch‬ﺷﺒﻜﺔ اﻻﺗﺼﺎﻻت اﻟﻌﺎﻟﻤﻴﺔ‪https: //‬ﻣﻠﺨﺼﻤﻨﺎﻟﻤﻨﺘﺠﺨﺼﺎﺋﺺ‪1.carbetocinferring‬‬
‫‪009770.‬ﻛﻮﻛﺮﻳﻨﻘﺎﻋﺪة ﺑﻴﺎﻧﺎت‪syst‬ﻣﺮاﺟﻌﺔ ‪2018‬؛ ‪ : 7‬اﻟﻘﺮص اﻟﻤﻀﻐﻮط ‪.‬وآﺧﺮونﷲ‪2. leathersichsj،‬‬
‫ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻹﻋﻼﻧ ﺈ ﺳ ﻌ ﺎ ﻓ ﻤ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪│carbetocin‬و ﺣ ﺪ ة‬

‫‪1‬ﻣ ﻮ ا ﻧ ﻊ ‪hsc-‬‬

‫‪:‬اﻟﻤﺴﺘﺨﺪﻣﺔ‪e‬ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﺠﺐ أﻧﻠﻴﺴﺐ‪-‬اﻟﺤﺮارة‬
‫ﻟﻠﺤﺼﻮل ﻋﻠﯩﻌﻤﻼﻟﺤﺜﺄوﻋﻤﻠﺘﻜﺒﻴﺮ‪.‬‬
‫‪irth‬ﺧﻼﻟﺤﻤﻠﻮﻋﻤﻠﻘﺒﻼل‪.childb‬‬
‫اﺿﻄﺮاﺑﺎت‪r‬ﻓﻴﻨﺴﺎءﻣﻌﺠﺪي‪.cardiovascula‬‬
‫ﻓﻴﻨﺴﺎءﻣﻌﻜﺒﺪﻳﺄواﻟﻜﻠﻮﻳﺎﺿﻄﺮاﺑﺎت‪.‬‬
‫ﻓ ﻴﻨﺴﺎ ء ﻣﻌﺎﻟ ﺼ ﺮع ‪.‬‬
‫اﻷوﻛﺴﻴﺘﻮﺳﻴﻦ ‪،‬ﻓﻴﻨﺴﺎءﻣﻌﻔﺮط اﻟﺤﺴﺎﺳﻴﺔإﻟﻰ‪. carbetocin‬‬
‫أوأﻳﻤﻨﺎﻻﻟﺴﻮاﻏﺎﺗﺒﺎﻟﻨﺴﺒﺔ اﻟﯩﺈﻟﯩﺎﻟﺘﻜﻮﻳﻦ‬

‫‪2021).‬آﺧﺮاﻟﻮﺻﻮﻟﻴﻮﻟﻴﻮ(أون=‪/‬؟ﻻﻧﻎ‪.swissmedicinfo.ch‬ﺷﺒﻜﺔ اﻻﺗﺼﺎﻻت اﻟﻌﺎﻟﻤﻴﺔ‪https: //‬ﻣﻠﺨﺼﻤﻨﺎﻟﻤﻨﺘﺠﺨﺼﺎﺋﺺ‪1.carbetocinferring‬‬

‫ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻹﻋﻼﻧ ﺈ ﺳ ﻌ ﺎ ﻓ ﻤ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪│carbetocin‬و ﺣ ﺪ ة‬

‫‪ngs 1‬ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪-carbetocinwarni‬ا ﻟ ﺤ ﺮ ا ر ة‬

‫اﻻﺳﺘﻌﻤﺎﻟﻤﻨﻠﻠﺤﺮارة ﻣﺴﺘﻘﺮة‪carbetocin‬ﻓﻴﺄﻳﺎﻟﻤﺴﺮﺣﻘﺒﻠﺨﺪﻣﻪ ‪.‬‬

‫ﺗﻮﺻﻴﻠﻤﻨﺎﻟﻄﻔﻞ رﺿﻴﻌﻴﻜﻮﻧﻠﻴﺴﺎﻟﻤﻨﺎﺳﺒﻼﻧﺪورﺗﻬﺎ‬
‫ﻧﺸﺎﻃﺎﺳﺘﻤﺮﺗﻠﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻌﺪﻳﺪ ﻣﻨﺴﺎﻋﺎت‪uterotonic‬‬
‫ﻗﺒﻼﻻدارة)ﻋﺪةاﻟﺤﻤﻞ(ﻗﺎﻋﺪةﺧﺎرﺟﺎﻟﻮﺟﻮدﻣﻨﺄﺧﺮﯨﻄﻔﻞ‪.‬‬
‫ﻟﻠﺤﺮارة ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻜﻮﻧﺒﻄﻼﻧﺨﻼل‪.‬‬
‫اﻟﺤﻤﻞ‪،‬ﻣﻦ ﺿﻤﻨﻬﺎﻟﻠﺤﺼﻮل ﻋﻠﯩﺎﻻﻟﺤﺜﻤﻨﻌﻤﻞ‬
‫ﻗﻄﺤﻘﻨﻠﻠﺤﺮارة ﻣﺴﺘﻘﺮة‪carbetocin‬ﻗﺒﻼﻟﻮﻻدةﻣﻦ‬
‫اﻻﻟﺮﺿﻊ!‬

‫‪2021).‬آﺧﺮاﻟﻮﺻﻮﻟﻴﻮﻟﻴﻮ(أون=‪/‬؟ﻻﻧﻎ‪.swissmedicinfo.ch‬ﺷﺒﻜﺔ اﻻﺗﺼﺎﻻت اﻟﻌﺎﻟﻤﻴﺔ‪https: //‬ﻣﻠﺨﺼﻤﻨﺎﻟﻤﻨﺘﺠﺨﺼﺎﺋﺺ‪1.carbetocinferring‬‬

‫ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻹﻋﻼﻧ ﺈ ﺳ ﻌ ﺎ ﻓ ﻤ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪│carbetocin‬و ﺣ ﺪ ة‬

‫ﺗ ﻜ ﻮ ﻳ ﻨ ﻮ ا ﻟ ﺘ ﻌ ﺒ ﺌ ﺔ و ا ﻟ ﺘ ﻐ ﻠ ﻴ ﻒ ‪hsc-‬‬

‫)‪carbetocinferringtm(hsc‬‬
‫أﻣﺒﻮﻻﺗﻠﻜﻠﻤﺮﺑﻊ(ﻣﺎ ﻳﻜﻔﻴﻠﻠﺤﺼﻮل ‪10‬ﺗﺠﺎرﻳﺤﺰﻣﻴﺤﺘﻮي ‪.‬‬
‫ﻋﻠﻰ‪10‬اﻟﻤﺮﺿﻰ)‬
‫ا ﻟ ﺤ ﺰ ﻣ ﺔ ﺗ ﻤ ﺘ ﻌ ﻠ ﯩ ﺎ ﻟ ﺒ ﺮ ﺗ ﻘ ﺎ ﻟ ﻴ ﺨﻠ ﻔ ﻴ ﺔ إ ﻟ ﻰ ‪.‬‬
‫أﻣﺒﻮﻻ ‪.‬اﻟﺘﻔﺮﻳﻘﻤﻌﺄﺧﺮى‪uterotonic‬اﻟﻤﺨﺪرات‬
‫‪100‬ﻛﻠﺘﺤﺘﻮي ‪1ml،‬ﺗﻤﻦ‬
‫‪1‬ﻣ ﻴ ﻜ ﺮ و ﻏ ﺮ ا ﻣ ﻤ ﻦ ‪carbetocin‬‬

‫اﻟﺤﻞ ‪،‬ﻓﻴﺈﺿﺎﻓﺔإﻟﻰ‪. carbetocin‬‬

‫ﻳﺤﺘﻮي ﻋﻠﯩﻤﺎء؛‪-l‬اﻟﻤﻴﺜﻴﻮﻧﻴﻦ؛اﻟﺴﻜﺴﻴﻨﻴﻜﺤﻤﺾ؛‬
‫‪1‬ﺻﻮدﻳﻮﻣﻬﻴﺪروﻛﺴﻴﺪ‪mannitoland‬‬

‫‪2021).‬آﺧﺮاﻟﻮﺻﻮﻟﻴﻮﻟﻴﻮ(أون=‪/‬؟ﻻﻧﻎ‪.swissmedicinfo.ch‬ﺷﺒﻜﺔ اﻻﺗﺼﺎﻻت اﻟﻌﺎﻟﻤﻴﺔ‪https: //‬ﻣﻠﺨﺼﻤﻨﺎﻟﻤﻨﺘﺠﺨﺼﺎﺋﺺ‪1.carbetocinferring‬‬

‫ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻹﻋﻼﻧ ﺈ ﺳ ﻌ ﺎ ﻓ ﻤ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪│carbetocin‬و ﺣ ﺪ ة‬

‫‪1‬ﻣ ﻨ ﻌ ﻤ ﻦ ‪pph‬‬

‫ﻧﺸﻴﻄﺈدارةﻣﻨﺎﻻﻟﺜﺎﻟﺜﺎﻟﻤﺴﺮﺣﻤﻨﻌﻤﻠﻴﻘﻠﻼﻷﻣﻬﺎﺗﺪﻣﺨﺴﺎرةوﻳﻘﻠﻼﻟﺨﻄﺮﻣﻦ‪. pph‬‬
‫ﻳﺴﺘﻨﺪاﻟﺘﺪﺧﻠﻤﻌﻤﺤﺘﻤﻺﻟﻰ‪r‬اﺳﺘﻨﺘﺞ ‪pph‬ذات ‪-‬اﻻدارةﻣﻨﺎوﻗﺎﺋﻴﺔ‪uterotonic‬ﻓﻮراﺑﻌﺪ‪ ،‬ﺑﻌﺪﻣﺎوﻻدةﻳﻜﻮﻧﻌﻠﯩﺪﻟﻴﻞ ‪.‬‬
‫اﻟﺼﻠﺔاﻟﻮﻓﻴﺎت‬
‫‪2‬دﻗﻴﻘﺔﺑﻌﺪ‪ ،‬ﺑﻌﺪﻣﺎاﻻﻟﻮﻻدة ‪1‬اﻟﻤﻦ اﻟﺬﯨﺘﻮﺻﻴﺈﻟﯩﻴﻌﻄﯩﺎل‪uterotonic‬ﻓﻲ ﻏﻀﻮن ‪.‬‬
‫وﻳﻔﻀﻠﻘﺒﻼل‪،‬إدارةﻣﺜﻠﻘﺮﻳﺒﺎﻣﺜﻠﻤﻤﻜﻨﺒﻌﺪ‪ ،‬ﺑﻌﺪﻣﺎﺧﺪﻣﻪ ﺗﻮﺻﻴﻞ‪:‬ﻣﺴﺘﻘﺮة‪carbetocinswissmedic‬اﻟﺘﺴﻤﻴﺔ‪-‬اﻟﺤﺮارة‪.‬‬
‫‪3‬ﻳﻜﻮﻧﺴﻠﻤﺖ‪placenta‬‬

‫ﻟﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻦ‪uterotonicpph‬اﻟﺘﻮاﺋﻤﺄوأﻛﺜﺮ)ﻗﺒﻺدارةا(‪ncy‬ﻗﺎﻋﺪةﺧﺎرﺟﻌﺪة‪pregna‬‬

‫ﻛﻮﻛﺮﻳﻨﻘﺎﻋﺪة ﺑﻴﺎﻧﺎت‪syst‬ﻣﺮاﺟﻌﺔ ‪.2018‬؛ ‪. 12.‬وآﺧﺮونﷲ‪،‬ﻫﻮﻳﺔ ﺷﺨﺼﻴﺔ‪1.gallos‬‬

‫‪.‬اﻟﻌﺎﻟﻤﺼﺤﺔ اﻟﻤﻨﻈﻤ ﺔ ‪.‬ﻣ ﻦ اﻟﺬ ﯨﺎﻟﺘ ﻮﺻﻴﺎت ‪uterotonics:‬ﻟﻠ ﺤﺼﻮ ل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺒﻌﺪ اﻟﻮﻻدةاﻟﻨﺰﻳﻒ‪2018.،‬ﻣﺘﻮﻓﺮةﻓﻲ ‪2:‬‬
‫‪2021).‬ﺷﻬﺮ ﺳﺒﺘﻤﺒﺮ ‪:‬آﺧﺮاﻟﻮﺻﻮل (‪ua= 1 &ua= 1‬ﻗﻮات اﻟﺪﻓﺎع اﻟﺸﻌﺒﻲ؟ ‪.‬اﻟﻤﻬﻨﺪس ‪/ 10665/277276 / 9789241550420-‬ﻣﻘﺒﺾ ‪/Bitstream/‬اﻟﻘﺰﺣﻴﺔ ‪/‬اﻟﺒﺎﺣﺚ ‪.‬ﻣﻦ اﻟﺬى ‪.‬ﺗﻄﺒﻴﻘﺎت ‪https: //‬‬
‫(آ ﺧ ﺮ ا ﻟ ﻮ ﺻ ﻮ ﻟ ﻴ ﻮ ﻟ ﻴ ﻮ ‪lang=en2021).‬؟ ‪.swissmedicinfo.ch/‬ﺷ ﺒ ﻜ ﺔ اﻻ ﺗ ﺼ ﺎﻻت ا ﻟ ﻌ ﺎ ﻟ ﻤ ﻴ ﺔ ‪https: //‬ﻣ ﻠ ﺨ ﺼ ﻤ ﻨ ﺎ ﻟ ﻤ ﻨ ﺘ ﺠ ﺨ ﺼ ﺎ ﺋ ﺺ ‪3.carbetocinferring‬‬
‫ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻹﻋﻼﻧ ﺈ ﺳ ﻌ ﺎ ﻓ ﻤ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪│carbetocin‬و ﺣ ﺪ ة‬

‫]‪1 [1/4‬اﻻ د ا ر ة ‪hsc-‬‬

‫ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﺠﺐ أﻧﻜﻦ‪inje‬اﻟﻤﺪﻳﺮﻳﺔ اﻟﺘﻨﻔﻴﺬﻳﺔﻣﺜﻠﻘﺮﻳﺒﺎﻣﺜﻠﻤﻤﻜﻨﺒﻌﺪ‪ ،‬ﺑﻌﺪﻣﺎاﻟﻮﻻ‪-‬اﻟﺤﺮارة‬

‫د ة ﻣ ﻨ ﺎ ﻟ ﻄ ﻔ ﻞ ر ﺿ ﻴ ﻌ ﻮ و ﻳ ﻔ ﻀ ﻠ ﻘ ﺒ ﻠ ﺨ ﺪ ﻣ ﻪ ﺗ ﻮ ﺻ ﻴ ﻠ ﻤ ﻨ ﺘ ﻮ ﻗ ﺎ ل ا ﻧ ﻬ ﺎ ﻟﻤ ﺸ ﻴﻤ ﺔ‬
‫اﻟﺜﺎﻟﺜﺎﻟﻤﺴﺮﺣﻤﻨﻌﻤﻞ‬

‫وﻻدةﻣﻨﺎﻟﻄﻔﻞ رﺿﻴﻊ‬ ‫ﺧﺪﻣﻪ ﺗﻮﺻﻴﻠﻤﻨﺎﻻﻟﻤﺸﻴﻤﺔ‬

‫‪hsc‬‬

‫ﻳﻨﺒﻐﻴﻔﻘﻄﻜﻦ‪hsc‬‬ ‫‪tation.‬ﺟﻌﻠﻤﺘﺄﻛﺪﻫﺬﻫﻴﻜﻮﻧﻠﻴﺴﺎﻋﺪةﻏﻴﺲ‬
‫ﺗﺪارﺑﻮاﺳﻄﺔاﻟﻤﻬﺮة‬ ‫ﻓﻌﻠﻼﺗﺤﻘﻦ‪،hsc.‬ﻟﻮأﺧﺮﯨﻄﻔﻠﻴﻜﻮﻧﺤﺎﺿﺮ‬
‫‪.‬ﺻﺤﺔﺷﺆون ﻣﻮﻇﻔﻴﻦ‬ ‫ﺣﻘﻦ‪hsc‬ﺑﻌﺪ‪ ،‬ﺑﻌﺪﻣﺎﻛﻠﻤﻨﺎﻻﻃﻔﺎل رﺿﻌﻬﻠﻮﻟﺪ‪.‬‬

‫‪2021).‬آﺧﺮاﻟﻮﺻﻮﻟﻴﻮﻟﻴﻮ(أون=‪/‬؟ﻻﻧﻎ‪.swissmedicinfo.ch‬ﺷﺒﻜﺔ اﻻﺗﺼﺎﻻت اﻟﻌﺎﻟﻤﻴﺔ‪https: //‬ﻣﻠﺨﺼﻤﻨﺎﻟﻤﻨﺘﺠﺨﺼﺎﺋﺺ‪1.carbetocinferring‬‬

‫ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻹﻋﻼﻧ ﺈ ﺳ ﻌ ﺎ ﻓ ﻤ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪│carbetocin‬و ﺣ ﺪ ة‬

‫]‪1 [2/4‬اﻻ د ا ر ة ‪hsc-‬‬

‫‪iv‬ﻋﻦ ﻃﺮﻳﻖ اﻟﺤﻘﻦ‪r‬اﻟﺤﻠﻔﻴﺎﻷﻣﺒﻮﻟﺔﻳﻜﻮﻧﻠﻠﺤﺼﻮل ﻋﻠﯩﺎﺳﺘﻌﻤﺎﻟﻤﺨﻔﻒ‪fo‬‬

‫واﻟﻌﻀﻠﻲ‪im‬ﺣﻘﻨﺔ‬

‫‪injection‬ﻣﺤﻘﻨﺔﻟﻠﺤﺼﻮل ﻋﻠﻰ‪2ml‬اﺳﺘﻌﻤﺎﻻ‬

‫‪1‬أﻣﺒﻮﻟﺔ‪،‬ﻟﻴﺴﺎﻟﻤﺨﻔﻒ‬ ‫اﻷﻣﺒﻮﻟﺔﺣﻠﻴﻨﺒﻐﻴﻠﻴﺴﻜﻨﺎﻟﻤﺨﻔﻔﻘﺒﻠﺤﻘﻨﺔ‬

‫واﺣﺪأﻣﺒﻮﻟﺔﻣﻦ‪1ml(100‬ﻣﻴﻜﺮوﻏﺮام)ﻳﻜﻮﻧﺎﻻﻟﺠﺮﻋﺔﻟﻠﺤﺼﻮل ﻋﻠﯩﻮاﺣﺪاﻟﻤﺮﻳﺾ‬

‫ﻣﺜﻠﻔﺈﻧﻬﺘﻤﺘﻠﻴﺴﺘﻤﺪرﺳﺖ‪nded‬إدارةاﻟﻤﺰﻳﺪﻣﻨﻮاﺣﺪاﻟﺠﺮﻋﺔﻳﻜﻮﻧﻠﻴﺲ‪recomme‬‬

‫‪.‬ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻜﻮﻧﺄﺷﺎرﺗﻠﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺎﻟﺮﺣﻤﺎﻟﻨﺰﻓﻨﻈﺮاإﻟﯩﺒﻌﺪ اﻟﻮﻻدةاﻟﺮﺣﻤﻐﻴﺮ ﻣﺸﺪد‪-‬اﻟﺤﺮارة*‬

‫اﻟﻌﻀﻠﻲ‪im:‬داﺧﻞ اﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ؛‪iv:‬‬
‫‪2021).‬آﺧﺮاﻟﻮﺻﻮﻟﻴﻮﻟﻴﻮ(أون=‪/‬؟ﻻﻧﻎ‪.swissmedicinfo.ch‬ﺷﺒﻜﺔ اﻻﺗﺼﺎﻻت اﻟﻌﺎﻟﻤﻴﺔ‪https: //‬ﻣﻠﺨﺼﻤﻨﺎﻟﻤﻨﺘﺠﺨﺼﺎﺋﺺ‪1.carbetocinferring‬‬
‫ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻹﻋﻼﻧ ﺈ ﺳ ﻌ ﺎ ﻓ ﻤ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪│carbetocin‬و ﺣ ﺪ ة‬

‫]‪1 [3/4‬اﻻ د ا ر ة ‪hsc-‬‬

‫ﻟﻠﺤﺼﻮل ﻋﻠﻰ‪iv‬ﺣﻘﻨﺔ‬
‫ﻟﻠﺤﺮارة ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻤﻜﻨﻜﻨﺘﺪار‬ ‫م‪n‬‬

‫ﻓﻴﻜﻼﻫﻤﺎاﻟﻤﻬﺒﻠﻴﺔوﻻدةووﻻدة ﻗﻴﺼﺮﻳﺔﻗﺴﻢ‪.‬‬
‫‪wly‬ﺗﺪار‪)slo‬ﻣﻴﻜﺮوﻏﺮام‪1ml(100‬‬
‫‪.‬ﻣﻴﻨﺎء‪v‬دﻗﻴﻘﺔﻣﺒﺎﺷﺮةﻓﻴﺎﻷﻧﺎ‪1‬ﻋﻠﻰ ﻣﺪى‬ ‫ﺣﻘﻨﻌﻠﻰ ﻣﺪى‪1‬اﻟﺤﺪ اﻷ‬

‫ﻓﻌﻠﻠﻴﺴﺤﻘﻦ‪hsc‬‬
‫إﻟﯩﺎﻟﺪاﺧﻞ اﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔﻣﺎﺋﻌﻜﻴﺲ‬

‫‪.‬داﺧﻞ اﻷوﻋﻴﺔ اﻟﺪﻣﻮﻳﺔ‪iv:‬‬

‫‪2021).‬آﺧﺮاﻟﻮﺻﻮﻟﻴﻮﻟﻴﻮ(أون=‪/‬؟ﻻﻧﻎ‪.swissmedicinfo.ch‬ﺷﺒﻜﺔ اﻻﺗﺼﺎﻻت اﻟﻌﺎﻟﻤﻴﺔ‪https: //‬ﻣﻠﺨﺼﻤﻨﺎﻟﻤﻨﺘﺠﺨﺼﺎﺋﺺ‪1.carbetocinferring‬‬
‫وﺣﺪة‬ ‫│‬ ‫‪blecarbetocin‬ﺳ ﺘ ﺎ ‪-‬ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻻ د ا ر ة ﻣ ﻨ ﺎ ﻟ ﺤ ﺮ ا ر ة‬

‫]‪1 [4/4‬اﻻ د ا ر ة ‪hsc-‬‬

‫‪For i‬‬ ‫ﺣ ﻘﻨ ﺔ‬
‫ﻣﻴﻜﺮوﻏﺮام)ﻳﻤﻜﻨﺄﻳﻀﺎﻛﻦ‪1ml(100‬‬
‫ﺗﺪاراﻟﻌﻀﻞ‪.‬‬

‫‪.‬اﻟﻌﻀﻠﻲ‪im:‬‬
‫‪lang=en‬؟‪.swissmedicinfo.ch/‬ﺷﺒﻜﺔ اﻻﺗﺼﺎﻻت اﻟﻌﺎﻟﻤﻴﺔ‪https: //‬ﻣﻠﺨﺼﻤﻨﺎﻟﻤﻨﺘﺠﺨﺼﺎﺋﺺ‪1.carbetocinferring‬‬ ‫(آﺧﺮاﻟﻮﺻﻮﻟﻴﻮﻟﻴﻮ‪2021).‬‬
‫ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻹﻋﻼﻧ ﺈ ﺳ ﻌ ﺎ ﻓ ﻤ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪│carbetocin‬و ﺣ ﺪ ة‬

‫‪1‬ﻟ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪carbetocin‬ا ﻟ ﺘ ﻔ ﺎ ﻋ ﻼت‬

‫ﻟﻠﺤﺮارة ﻣﺴﺘﻘﺮة‪carbetocin‬ﻳﻤﻜﻨﻜﻨﺘﺪارﻟﻠﺤﺼﻮل ﻋﻠﯩﻤﻨﻌﻤﻦ* ‪pph‬وﺣﺘﯩﻠﻮاﻷ‪.‬‬

‫ﺟﻴﻌﻤﻞ‪dur‬ﻳﻤﻠﻜﺘﻤﻤﻌﻄﻰ‪uterotonics‬وﻛﺴﻴﺘﻮﺳﻴﻨﺄوأﺧﺮى‬
‫إﺗﺒﻌﻤﺤﻠﻴﺒﺮوﺗﻮﻛﻮﻻت‪*،‬ﻣﺴﺘﻘﺮة‪carbetocin‬ﻟﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻦ‪-pph‬ﻟﻮﻧﺰﻳﻔﻴﺤﺪﺛﺒﻌﺪ‪ ،‬ﺑﻌﺪﻣﺎاﻻدارةﻣﻨﺎﻟﺤﺮارة‪.‬‬
‫أو‪uterotonics‬ﻳﻤﻜﻨﻜﻨﺘﺪارﺑﺎﻟﻨﺴﺒﺔ اﻟﯩﺈﻟﯩﻤﺤﻠﻴﻤﻌﺎﻳﻴﺮ‪/‬ﺣﻤﻀﻮ‪.tranexamic‬‬

‫‪،‬ﺗﻤﺘﺘﻤﺘﺪارﻓﻴﺠﻤﻌﻴﺔﻣﻌﺎﻟﻤﺴﻜﻨﺎت ‪،carbetocinferring‬ﺧﻼﻻﻟﺴﺮﻳﺮﻳﺔاﻟﻤﺤﺎﻛﻤﺎت ‪.‬ﻻاﻟﺘﻔﺎﻋﻠﺪراﺳﺎﺗﻴﻤﻠﻜﺘﻤﻘﺎﻣﺘﻤﻊ ‪carbetocin‬‬

‫ﻣﻀﺎدات ﺣﻴﻮﻳﺔ‪،‬ﻣﻀﺎدات اﻟﻔﻴﺮوﺳﺎت اﻟﻘﻬﻘﺮﻳﺔ‪spasmolytics،‬و‬
‫و ﻛ ﻼ ء ﻣ ﺴ ﺘ ﻌ ﻤ ﻠ ﺔ ﻟ ﻠ ﺤ ﺼ ﻮ ل ﻋ ﻠ ﯩ ﻔ ﻮ ق ا ﻟ ﺠ ﺎ ﻓ ﻴ ﺔ أ و ا ﻟ ﻌ ﻤ ﻮ د ا ﻟ ﻔ ﻘ ﺮ ﻳ ﺎ ﻟ ﺘ ﺨ ﺪ ﻳ ﺮ ‪.‬ﻻ ا ﻟ ﻤ ﺨ ﺪ ر ا ﺗ ﺎ ﻟ ﺘ ﻔ ﺎ ﻋ ﻼ ﺗ ﻜ ﺎ ﻧ ﻮ اﻻ ﺣ ﻆ ‪.‬‬

‫‪.‬ﻧﻈﺮاإﻟﯩﺒﻌﺪ اﻟﻮﻻدةاﻟﺮﺣﻤﻐﻴﺮ ﻣﺸﺪد ‪hage‬ﻣﺴﺘﻘﺮة ‪carbetocin‬ﻳﻜﻮ ﻧﺄﺷﺎرﺗﻠﻠﺤﺼﻮ ل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺎﻟﺮ ﺣﻢ ‪-haemorr‬اﻟﺤﺮ ارة *‬

‫(آ ﺧ ﺮ ا ﻟ ﻮ ﺻ ﻮ ﻟ ﻴ ﻮ ﻟ ﻴ ﻮ ‪lang=en2021).‬؟ ‪https://www.swissmedicinfo.ch/‬ﻣ ﻠ ﺨ ﺼ ﻤ ﻨ ﺎ ﻟ ﻤ ﻨ ﺘ ﺠ ﺨ ﺼ ﺎ ﺋ ﺺ ‪1.carbetocinferring‬‬
‫ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻹﻋﻼﻧ ﺈ ﺳ ﻌ ﺎ ﻓ ﻤ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪│carbetocin‬و ﺣ ﺪ ة‬

‫‪1‬ا ﻟ ﺘ ﺨ ﺰ ﻳ ﻦ ‪hsc-‬‬

‫ﻟﻠﺤﺮارة ﻣﺴﺘﻘﺮة‪carbetocin‬ﺑﻘﺎﻳﺎﻣﺴﺘﻘﺮةﻟﻠﺤﺼﻮل ﻋﻠﻰ‪48‬أﺷﻬﺮ‬

‫ﻗﺮﻳﺒﺎﻟﺮﻃﻮﺑﺔ‪75٪‬و‪30 °c‬ﻟﻮﻣﺨﺰﻧﺄدﻧﺎه‬
‫‪).‬واﻓﻘﺎﻟﺘﺨﺰﻳﻨﺎﻟﻈﺮوف (‬

‫اﻟﺒﻴﺎﻧﺎﺗﻴﻜﻮﻧﻤﺘﻮﻓﺮةدﻋﻤﺄﻋﻠﯩﺪرﺟﺔ اﻟﺤﺮارة‬
‫‪2‬اﻧﺤﺮاﻓﺎﺗﺨﻼﻻﻟﻤﻮاﺻﻼت‪.‬‬

‫أﻣﺒﻮﻻﺗﻴﺠﺐ أﻧﻜﻨﺄﺑﻘﯩﻔﻴﺎل‬ ‫ﻓﺈﻧﻬﻴﺠﺐ أﻧﻜﻨﻤﺴﺘﻌﻤﻠﺔﻗﺒﻼﻟﻤﺪة‬

‫ﻓﻌﻠﻠﻴﺴﺘﺠﻤﻴﺪ‬ ‫اﻟﺨﺎرﺟﻴﻜﺮﺗﻮﻧﺈﻟﯩﻴﺤﻤﻴﺎل‬ ‫اﻟ ﺼﻼ‬
‫اﻟﻤﻨﺘﺠﻤﻦ ﻋﻨﺪﺿﻮءﺧﻼﻻﻟﺘﺨﺰﻳﻦ‬ ‫‪.‬إﻛﺴﺐ "ﺣﻴﺔﺗﺎرﻳﺨﻤﻠﺤﻮظ‬

‫‪): e3082.‬اﻟﺨﻴﺎل اﻟﻌﻠﻤﻲ‪.2018‬؛‪.jpept 24 (6‬م‪،‬وآﺧﺮونﷲ‪(2.malm‬آﺧﺮاﻟﻮﺻﻮﻟﻴﻮﻟﻴﻮ‪lang=en2021).‬؟‪https://www.swissmedicinfo.ch/‬اﻟﺘﺸﻨﺠﺎت اﻟﻼإرادﻳﺔ‪characteris‬ﻣﻠﺨﺼﻤﻨﺎﻟﻤﻨﺘﺞ‪1.carbetocinferring‬‬

‫ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻹﻋﻼﻧ ﺈ ﺳ ﻌ ﺎ ﻓ ﻤ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪│carbetocin‬و ﺣ ﺪ ة‬

‫ا ﻟ ﺪ و ا ﺋ ﻴ ﺔ ‪hsc-‬‬

‫اﻟﻘﺎﺑﻼت‪،‬اﻟﻄﺒﻴﺐ‪،‬ﻣﻤﺮﺿﺔ‪،‬اﻟﻤﺮﻳﻀﻮﻗﺮﻳﺒﻴﻨﺒﻐﻴﺘﻘﺮﻳﺮأي‬
‫اﻟﻤﺤﻠﻴﻮزارةﻣﻨﺼﺤﺔ‪arbetocinto‬ﻣﺴﺘﻘﺮة‪-c‬اﻟﺴﻠﺒﻴﺔاﻟﻤﺨﺪراﺗﺮد ﻓﻌﻺﻟﯩﺎﻟﺤﺮارة‬
‫)ﻛﺴﻜﺴﻜﺴﻜﺴﻜﺲ‪(+xxxxxxxx‬رﻗﻢ‬
‫ﺳﺎﻟﻄﺎوﻟﺔ‪carbetocin‬اﻟﺪواﺋﻴﺔ‪-:‬وإﻟﯩﺎﻻﻟﻤﺼﻨﻌﺒﺮﻳﺪ اﻟﻜﺘﺮوﻧﯩﻠﻠﺤﺼﻮل ﻋﻠﯩﺎﻟﺤﺮارة‪/‬أو‬

‫‪safetymailboxcarbetocin@ferring.com‬‬
‫ا ﻟ ﺘ ﺪ ر ﻳ ﺒ ﻔ ﻴ ﺎﻻﻹﻋﻼﻧ ﺈ ﺳ ﻌ ﺎ ﻓ ﻤ ﻨ ﻠ ﻠ ﺤ ﺮ ا ر ة ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪│carbetocin‬و ﺣ ﺪ ة‬

‫ﻣ ﺴ ﺘ ﻘ ﺮ ة ‪carbetocin‬ﻓ ﻴ ﻤ ﺠ ﻤ ﻮ ﻋ ﻤ ﺎ ر ي ‪-‬ا ﻟ ﺤ ﺮ ا ر ة‬

‫ﻳ ﻜ ﻮ ﻧﺎ ﻣ ﻨ ﻈ ﻤ ﺔ ا ﻟ ﺼ ﺤ ﺔ ا ﻟ ﻌ ﺎ ﻟ ﻤ ﻴ ﺔ ‪ ،‬أ و ﺻ ﺖ ‪.‬‬ ‫‪cin‬ﻣﺴﺘﻘﺮة‪carbetocin‬و‪-oxyto‬اﻟﺤﺮارة‪.‬‬

‫ﻟﻠﺤﺼﻮل ‪uterotonic‬‬ ‫ﻳﻤﻠﻜﺎلﻣﻌﻈﻤﻤﻼﺋﻤﺠﺎﻧﺒﺘﺄﺛﻴﺮاﻟﻤﻠﻒ اﻟﺸﺨﺼﻲﻣﻦ‬
‫‪pph‬ﻣﻦ‪n‬ﻋﻠﯩﺎل‪preventio‬‬ ‫* ‪pph5‬ﺑﻴﻦ‪uterotonics‬إﻟﯩﻴﻤﻨﻊ‬
‫*وﻳﻜﻮﻧﻌﻠﯩﺎﻟﻤﺘﻮاﺟﺪوﻧﺎﻷﺳﺎﺳﻴﺔاﻷ‬
‫‪(eml)1‬دوﻳﺔﻗﺎﺋﻤﺔ‬ ‫ﻳﻜﻮﻧﺎﻟﻔﻘﻄﻌﻦ ﻃﺮﻳﻖ اﻟﺤﻘﻦ‪uterotonic‬أن‪.‬‬
‫ﻟﻠﺤﺼﻮل‪30 °c‬ﻳﻤﻜﻨﻜﻨﻤﺨﺰﻧﻔﻴﺎﻟﻮاﻓﻘﺎﻟﺘﺨﺰﻳﻨﺸﺮﻃﻔﻲ‬
‫‪.‬‬ ‫‪n2‬ﺗﻤﺘﺎﻳﻌﺪﻣﺪةﻣﻨﺎﻟﺮﺣﻤﻨﺸﺎﻃﻤﻦ‪oxytoci‬‬ ‫‪4‬أﺷﻬﺮ ‪48‬ﻋﻠﻰ‬
‫ﻳﻜﻮنﻣﻔﻴﺪﻟﻠﺤﺼﻮل ﻋﻠﯩﺎﺳﺘﻌﻤﺎﻟﻔﻲ‪.pph‬‬ ‫‪1 0 0‬أﻣﺒﻮﻟﺔﻣﻦ‪( 1 ml‬اﻟﺠﺮﻋﺔ ‪1‬ﻓﻘﻂ ‪.‬‬
‫ﻣﻨﻊ* ‪،‬ﻟﻜﻦ‪hsc‬ﻳﻨﺒﻐﻴﻠﻴﺴﻜﻨﻤﺴﺘﻌﻤﻠﺔﺧﻼﻟﺤﻤﻸ‬ ‫ﻣﻴﻜﺮوﻏﺮام )ﺣﻘﻦ ‪im‬أو ‪-iv‬ﻟﻠﺤﺼﻮل ﻋﻠﻰ‬
‫و‬ ‫‪4‬اﻟﻤﻬﺒﻠﻴﺔﺧﺪﻣﻪ ﺗﻮﺻﻴﻠﻮوﻻدة ﻗﻴﺼﺮﻳﺔﻗﺴﻢ‬
‫‪3،4‬ﻗﺒﻠﻮﻻدةﻣﻨﺎﻟﻄﻔﻞ‬

‫‪.‬ﻧﻈﺮاإﻟﯩﺒﻌﺪ اﻟﻮﻻدةاﻟﺮﺣﻤﻐﻴﺮ ﻣﺸﺪد ‪hage‬ﻣﺴﺘﻘﺮة ‪carbetocin‬ﻳﻜﻮ ﻧﺄﺷﺎرﺗﻠﻠﺤﺼﻮ ل ﻋﻠﯩﺎﻟﻤﻨﻌﻤﻨﺎﻟﺮ ﺣﻢ ‪-haemorr‬اﻟﺤﺮ ارة *‬

‫اﻻﺗﺤﺎد اﻟﻔﻠﻜﻲ ‪-‬اﻟﺸﺮاﻛﺔ اﻷورو‪-‬ﻣﺘﻮﺳﻄﻴﺔ ‪-‬ﻟﻘﺎح اﻟﺘﻬﺎب اﻟﺴﺤﺎﻳﺎ ‪-‬ﻣﻦ اﻟﺬى ‪/ 10665/325771 /‬ﻣﻘﺒﺾ ‪/Bitstream/‬اﻟﻘﺰﺣﻴﺔ ‪/‬اﻟﺒﺎﺣﺚ ‪.‬ﻣﻦ اﻟﺬى ‪.‬ﺗﻄﺒﻴﻘﺎت ‪:https: //‬ﻣﺘﻮﻓﺮةﻓﻲ ‪،2019.‬ﺳﺎﻧﺘﻘﺎﺋﻤﺔ ‪،21‬ﻧﻤﻮذﺟﻘﺎﺋﻤﺔﻣﻨﺎﻷﺳﺎﺳﻴﺔاﻷدوﻳﺔ ‪.‬اﻟﻌﺎﻟﻤﺼﺤﺔﻣﻨﻈﻤﺔ ‪1 .‬‬
‫آﺧﺮا ﻟ ﻮ ﺻ ﻮ ﻟ ﺸ ﻬ ﺮ ﺳ ﺒ ﺘ ﻤ ﺒ ﺮ ‪( 2021).‬ﻗﻮات اﻟﺪﻓﺎع اﻟﺸﻌﺒﻲ ‪.‬اﻟﻤﻬﻨﺪس ‪-2019.06-‬اﻟﺪوﻟﻲ‬
‫إدارةواﻟﺠﺮاﺣﻴﺔاﻟﺘﺪﺧﻞ ‪2006‬؛ ‪.113. - 98‬م‪2. prendivillew،o 'connell‬‬
‫ا ﻟ ﻌ ﺎ ﻟ ﻤ ﺼ ﺤ ﺔ ا ﻟ ﻤ ﻨ ﻈ ﻤ ﺔ ‪.‬ﻣ ﻦ ا ﻟ ﺬ ﯨ ﺎ ﻟ ﺘ ﻮ ﺻ ﻴ ﺎ ت ‪.uterotonics‬ﻟ ﻠ ﺤ ﺼ ﻮ ل ﻋ ﻠ ﯩ ﺎ ﻟ ﻤ ﻨ ﻌ ﻤ ﻨ ﺒ ﻌ ﺪ ا ﻟ ﻮ ﻻ د ة ا ﻟ ﻨ ﺰ ﻳ ﻒ ‪3..2018.‬‬
‫آﺧﺮ اﻟﻮﺻﻮﻟﻴﻮﻟﻴﻮ ‪(2021).‬أون =‪/‬؟ﻻ ﻧﻎ ‪.swissmedicinfo.ch‬ﺷﺒﻜﺔ اﻻﺗﺼﺎﻻت اﻟﻌﺎﻟﻤﻴﺔ ‪https: //‬ﻣﻠﺨ ﺼﻤﻨﺎﻟﻤﻨﺘ ﺠﺨﺼﺎﺋﺺ ‪4.carbetocinferring‬‬
‫‪011689.‬اﻟﻘﺮص اﻟﻤﻀﻐﻮط ‪(4):‬ﻛﻮﻛﺮﻳﻨﻘﺎﻋﺪة ﺑﻴﺎﻧﺎت‪syst‬ﻣﺮاﺟﻌﺔ ‪.(2018).‬وآﺧﺮونﷲ‪5.gallos،‬‬