EA200400551A1 - Система доставки лекарственного средства для седации с сохранением сознания - Google Patents
Система доставки лекарственного средства для седации с сохранением сознанияInfo
- Publication number
- EA200400551A1 EA200400551A1 EA200400551A EA200400551A EA200400551A1 EA 200400551 A1 EA200400551 A1 EA 200400551A1 EA 200400551 A EA200400551 A EA 200400551A EA 200400551 A EA200400551 A EA 200400551A EA 200400551 A1 EA200400551 A1 EA 200400551A1
- Authority
- EA
- Eurasian Patent Office
- Prior art keywords
- consciousness
- dosage level
- occurs
- anesthesia
- delivery
- Prior art date
Links
- 206010039897 Sedation Diseases 0.000 title 1
- 230000036280 sedation Effects 0.000 title 1
- 206010002091 Anaesthesia Diseases 0.000 abstract 2
- 230000037005 anaesthesia Effects 0.000 abstract 2
- 208000000044 Amnesia Diseases 0.000 abstract 1
- 208000031091 Amnestic disease Diseases 0.000 abstract 1
- 208000003443 Unconsciousness Diseases 0.000 abstract 1
- 230000006986 amnesia Effects 0.000 abstract 1
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 abstract 1
- 239000003814 drug Substances 0.000 abstract 1
- 229940079593 drug Drugs 0.000 abstract 1
- 238000012377 drug delivery Methods 0.000 abstract 1
- 239000003983 inhalation anesthetic agent Substances 0.000 abstract 1
- 229910052760 oxygen Inorganic materials 0.000 abstract 1
- 239000001301 oxygen Substances 0.000 abstract 1
- 230000036407 pain Effects 0.000 abstract 1
- 238000011084 recovery Methods 0.000 abstract 1
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/01—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes specially adapted for anaesthetising
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/045—Hydroxy compounds, e.g. alcohols; Salts thereof, e.g. alcoholates
- A61K31/05—Phenols
- A61K31/06—Phenols the aromatic ring being substituted by nitro groups
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M15/00—Inhalators
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/10—Preparation of respiratory gases or vapours
- A61M16/1005—Preparation of respiratory gases or vapours with O2 features or with parameter measurement
- A61M16/1015—Preparation of respiratory gases or vapours with O2 features or with parameter measurement using a gas flush valve, e.g. oxygen flush valve
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/10—Preparation of respiratory gases or vapours
- A61M16/1075—Preparation of respiratory gases or vapours by influencing the temperature
- A61M16/109—Preparation of respiratory gases or vapours by influencing the temperature the humidifying liquid or the beneficial agent
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/10—Preparation of respiratory gases or vapours
- A61M16/14—Preparation of respiratory gases or vapours by mixing different fluids, one of them being in a liquid phase
- A61M16/18—Vaporising devices for anaesthetic preparations
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P23/00—Anaesthetics
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/04—Centrally acting analgesics, e.g. opioids
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/20—Hypnotics; Sedatives
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/0087—Environmental safety or protection means, e.g. preventing explosion
- A61M16/009—Removing used or expired gases or anaesthetic vapours
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/10—Preparation of respiratory gases or vapours
- A61M16/1005—Preparation of respiratory gases or vapours with O2 features or with parameter measurement
- A61M16/101—Preparation of respiratory gases or vapours with O2 features or with parameter measurement using an oxygen concentrator
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/0027—Accessories therefor, e.g. sensors, vibrators, negative pressure pressure meter
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
- A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
- A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
- A61M2016/0039—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the inspiratory circuit
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. ventilators; Tracheal tubes
- A61M16/10—Preparation of respiratory gases or vapours
- A61M16/1005—Preparation of respiratory gases or vapours with O2 features or with parameter measurement
- A61M2016/102—Measuring a parameter of the content of the delivered gas
- A61M2016/1035—Measuring a parameter of the content of the delivered gas the anaesthetic agent concentration
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2202/00—Special media to be introduced, removed or treated
- A61M2202/02—Gases
- A61M2202/0208—Oxygen
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2209/00—Ancillary equipment
- A61M2209/08—Supports for equipment
- A61M2209/084—Supporting bases, stands for equipment
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/04—Heartbeat characteristics, e.g. ECG, blood pressure modulation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/08—Other bio-electrical signals
- A61M2230/10—Electroencephalographic signals
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/20—Blood composition characteristics
- A61M2230/205—Blood composition characteristics partial oxygen pressure (P-O2)
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/30—Blood pressure
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M2230/00—Measuring parameters of the user
- A61M2230/40—Respiratory characteristics
- A61M2230/43—Composition of exhalation
- A61M2230/432—Composition of exhalation partial CO2 pressure (P-CO2)
Landscapes
- Health & Medical Sciences (AREA)
- Anesthesiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Emergency Medicine (AREA)
- Pulmonology (AREA)
- Hematology (AREA)
- Heart & Thoracic Surgery (AREA)
- Chemical & Material Sciences (AREA)
- Pharmacology & Pharmacy (AREA)
- Medicinal Chemistry (AREA)
- General Chemical & Material Sciences (AREA)
- Chemical Kinetics & Catalysis (AREA)
- Bioinformatics & Cheminformatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Organic Chemistry (AREA)
- Neurosurgery (AREA)
- Neurology (AREA)
- Epidemiology (AREA)
- Pain & Pain Management (AREA)
- Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
- Medicinal Preparation (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
Abstract
Разработаны ингаляционные анестетики, обладающие рядом свойств, включающим в себя быстроту наступления эффекта и восстановления, управляемость и, в идеале, широкий профиль безопасности. Эффективность этих препаратов измеряется их способностью вызывать анестезию в совокупности с другими желательными свойствами. Настоящее изобретение сфокусировано на уровне дозировки, при которой наступает обезболивание, но не наступает амнезии или потери сознания. Кроме определения уровня дозировки, при которой резко снижается или совсем снимается боль, но сохраняется сознание, также предложена система для безвредной и эффективной доставки препарата. Система содержит систему (10) сопряженной индексации. Кислород из источника O(16) проходит по подающему трубопроводу (22), имеющему чувствительный регулятор (18) давления, к расходомеру (20).Отчет о международном поиске был опубликован 2003.12.24.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US33006301P | 2001-10-17 | 2001-10-17 | |
PCT/US2002/033190 WO2003033048A2 (en) | 2001-10-17 | 2002-10-17 | Drug delivery system for conscious sedation |
Publications (2)
Publication Number | Publication Date |
---|---|
EA200400551A1 true EA200400551A1 (ru) | 2004-08-26 |
EA008463B1 EA008463B1 (ru) | 2007-06-29 |
Family
ID=23288165
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EA200400551A EA008463B1 (ru) | 2001-10-17 | 2002-10-17 | Система доставки лекарственного средства для седации с сохранением сознания |
Country Status (20)
Country | Link |
---|---|
US (2) | US8393321B2 (ru) |
EP (2) | EP1443986B1 (ru) |
JP (2) | JP4846977B2 (ru) |
KR (1) | KR100954723B1 (ru) |
CN (1) | CN100431633C (ru) |
AP (1) | AP2116A (ru) |
AU (1) | AU2002362844B2 (ru) |
BR (1) | BR0213397B1 (ru) |
CA (1) | CA2463999C (ru) |
EA (1) | EA008463B1 (ru) |
ES (2) | ES2471460T3 (ru) |
HU (2) | HU229621B1 (ru) |
IL (2) | IL161463A0 (ru) |
MX (1) | MXPA04003567A (ru) |
NZ (1) | NZ532968A (ru) |
PL (1) | PL206780B1 (ru) |
TR (1) | TR200400811T2 (ru) |
UA (1) | UA83337C2 (ru) |
WO (1) | WO2003033048A2 (ru) |
ZA (1) | ZA200402850B (ru) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
RU2700377C1 (ru) * | 2018-09-26 | 2019-09-16 | Государственное бюджетное учреждение здравоохранения Московской области "Московский областной научно-исследовательский институт акушерства и гинекологии" (ГБУЗ МО МОНИИАГ) | Способ ингаляционной анальгезии севофлураном при самопроизвольных родах |
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ES2471460T3 (es) * | 2001-10-17 | 2014-06-26 | Piramal Critical Care, Inc. | Sistema de suministro de medicamentos para sedación consciente |
CN1723480A (zh) * | 2002-05-13 | 2006-01-18 | 斯科特实验室公司 | 用于医疗过程期间透明的早期检测、警告和干预的系统和方法 |
US7337776B2 (en) * | 2002-08-20 | 2008-03-04 | Aga Ab | Methods for easing pain and anxiety from atrial or ventricular defibrillation |
DE102006032860B4 (de) * | 2006-07-14 | 2011-07-14 | Dräger Medical GmbH, 23558 | Überwachungseinrichtung für eine Narkosevorrichtung und Verfahren |
WO2008112319A2 (en) * | 2007-03-15 | 2008-09-18 | The Curavita Corporation | Methods of treating parkinson's disease using halogenated volatile compounds |
US8267081B2 (en) | 2009-02-20 | 2012-09-18 | Baxter International Inc. | Inhaled anesthetic agent therapy and delivery system |
US9022959B2 (en) | 2009-07-30 | 2015-05-05 | Mcneil-Ppc, Inc. | Oral care systems |
US9022960B2 (en) | 2009-07-30 | 2015-05-05 | Mcneil-Ppc, Inc. | Oral care cleaning and treating device |
US9022961B2 (en) | 2009-07-30 | 2015-05-05 | Mcneil-Ppc., Inc. | Oral care cleaning and treating device |
US8192400B2 (en) * | 2009-08-18 | 2012-06-05 | Tam Weng Kong | Pneumatic injection device |
US9308064B2 (en) * | 2010-07-26 | 2016-04-12 | Johnson & Johnson Consumer Inc. | Devices and methods for collecting and analyzing fluid samples from the oral cavity |
US20130068222A1 (en) * | 2011-06-20 | 2013-03-21 | Klaus Michael SCHMIDT | Anesthetic circuit and a method for using the anesthetic circuit |
DE202011102764U1 (de) * | 2011-07-02 | 2011-12-05 | Dräger Medical GmbH | Beatmungssystem |
GB201116271D0 (en) * | 2011-09-21 | 2011-11-02 | Univ Cardiff | Dispersion anaesthetic device |
CN103127165B (zh) * | 2012-02-23 | 2015-03-11 | 李玉香 | 一种吸入镇痛剂及其制备方法与应用 |
EP3329966B1 (en) | 2012-07-10 | 2021-12-22 | The Regents of The University of California | Methods of inducing anesthesia |
US9622683B2 (en) | 2012-07-11 | 2017-04-18 | Financial Consultants Llc | Device for evacuating and/or monitoring gas leaking from a patient during surgery or anesthetization |
WO2014094139A1 (en) | 2012-12-22 | 2014-06-26 | Dmf Medical Incorporated | An anesthetic circuit having a hollow fiber membrane |
WO2014160398A1 (en) * | 2013-03-13 | 2014-10-02 | Microlin, Llc. | Trans-tympanic antioxidant delivery system |
FR3008883B1 (fr) * | 2013-07-23 | 2015-07-17 | Anesteo | Station d'anesthesie pour animaux de laboratoire et procede de determination du taux de saturation en halogenes des filtres d'une telle station d'anesthesie |
US20150027439A1 (en) * | 2013-07-29 | 2015-01-29 | Oregon Health And Science University | Anesthetic vaporizer |
WO2015187918A2 (en) | 2014-06-05 | 2015-12-10 | The Regents Of The University Of California | Halogenated ether compounds and methods of inducing anesthesia |
US10384031B1 (en) * | 2014-06-20 | 2019-08-20 | Mallinckrodt Hospital Products IP Limited | Systems and methods for manufacturing and safety of an NO2-to-NO reactor cartridge used to deliver NO for inhalation therapy to a patient |
FR3023487A1 (fr) * | 2014-07-10 | 2016-01-15 | Nixys | Dispositif perfectionne de distribution d’un melange gazeux d’oxygene o2 et d’un autre gaz medical |
FR3023488A1 (fr) * | 2014-07-10 | 2016-01-15 | Nixys | Procede de distribution ameliore d'un melange gazeux d'oxygene o2 medical et d'un autre gaz medical |
JP6253029B2 (ja) * | 2015-01-21 | 2017-12-27 | 大陽日酸株式会社 | 麻酔器用取付キット |
US20160361514A1 (en) * | 2015-06-15 | 2016-12-15 | Consort Medical Plc | Dispensing apparatus |
US11213258B2 (en) * | 2017-08-09 | 2022-01-04 | University of Pittsburgh—of the Commonwealth System of Higher Education | Variable index for determining patient status |
CN108568020A (zh) * | 2018-05-03 | 2018-09-25 | 浙江氙科医疗器械有限公司 | 便携式氙氧混合气体吸入装置中氙气瓶的固定机构 |
US11622751B2 (en) | 2018-12-19 | 2023-04-11 | Johnson & Johnson Consumer Inc. | Devices and methods for collecting saliva samples from the oral cavity |
RU2703116C1 (ru) * | 2019-06-13 | 2019-10-15 | Владимир Степанович Григорьев | Система оздоровления летучими веществами растительных носителей |
CN112642035B (zh) * | 2020-12-14 | 2023-02-28 | 中国医学科学院北京协和医院 | 一种口腔笑气镇静监测系统 |
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2002
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
RU2700377C1 (ru) * | 2018-09-26 | 2019-09-16 | Государственное бюджетное учреждение здравоохранения Московской области "Московский областной научно-исследовательский институт акушерства и гинекологии" (ГБУЗ МО МОНИИАГ) | Способ ингаляционной анальгезии севофлураном при самопроизвольных родах |
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