{"id":29772,"date":"2017-12-10T18:31:59","date_gmt":"2017-12-10T17:31:59","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=29772"},"modified":"2017-12-10T18:33:25","modified_gmt":"2017-12-10T17:33:25","slug":"cisarsky-rez-na-prani-aneb-selhani-predporodni-pripravy","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=29772","title":{"rendered":"C\u00edsa\u0159sk\u00fd \u0159ez na p\u0159\u00e1n\u00ed, …aneb selh\u00e1n\u00ed p\u0159edporodn\u00ed p\u0159\u00edpravy"},"content":{"rendered":"

C\u00edsa\u0159sk\u00fd \u0159ez z hlediska matky dnes bezpe\u010dn\u00e1 operace, ale existuj\u00ed kr\u00e1tkodob\u00e9 ale i dlouhodob\u00e9 v\u00fdsledky u d\u011bt\u00ed porozen\u00fdch c\u00edsa\u0159sk\u00fdm \u0159ezem, a ty tak pozitivn\u00ed nejsou.<\/strong><\/p>\n

Z\u00e1sadn\u00ed role novorozeneck\u00e9ho mikrobiomu p\u0159i vzniku \u0159ady nemoc\u00ed<\/strong><\/p>\n

Porod voliteln\u00fdm c\u00edsa\u0159sk\u00fdm \u0159ezem je ve srovn\u00e1n\u00ed s b\u011b\u017en\u00fdm vagin\u00e1ln\u00edm porodem spojen s rizikem vy\u0161\u0161\u00ed nemocnosti takto porozen\u00fdch d\u011bt\u00ed. Z kr\u00e1tkodob\u00e9ho hlediska p\u0159edstavuj\u00ed probl\u00e9m poruchy poporodn\u00ed adaptace novorozenc\u016f porozen\u00fdch c\u00edsa\u0159sk\u00fdmi \u0159ezy, jako v\u00fdznamn\u00e1 se ov\u0161em ukazuj\u00ed i dlouhodob\u00e1 zdravotn\u00ed rizika.<\/p>\n

\u201eJi\u017e dlouho jsou publikov\u00e1na epidemiologick\u00e1 data o vztahu mezi porodem d\u00edt\u011bte c\u00edsa\u0159sk\u00fdm \u0159ezem a n\u00e1sledn\u00fdm rozvojem obezity, astmatu, diabetu I. typu a neurov\u00fdvojov\u00fdch poruch mezi kter\u00e9 se \u0159ad\u00ed i poruchy autistick\u00e9ho spektra,\u201c upozor\u0148uje MUDr. Jan Sm\u00ed\u0161ek, neonatolog a pediatr z Gynekologicko-porodnick\u00e9 kliniky 1. LF UK a VFN v Praze.<\/p>\n

Rozvoj t\u011bchto chorob v d\u011btstv\u00ed m\u016f\u017ee podporovat rozvoj dal\u0161\u00edch, takzvan\u00fdch nep\u0159enosn\u00fdch (civiliza\u010dn\u00edch) chorob v dosp\u011blosti a celo\u017eivotn\u011b naru\u0161ovat zdrav\u00ed jednotlivce. V nov\u00fdch v\u00fdzkumech se ukazuje, \u017ee jedn\u00edm z d\u016fvod\u016f, kter\u00fd stoj\u00ed v pozad\u00ed t\u011bchto probl\u00e9m\u016f, je naru\u0161en\u00ed v\u00fdvoje novorozeneck\u00e9ho mikrobiomu, tedy souboru mikroorganism\u016f, kter\u00e9 za fyziologick\u00fdch okolnost\u00ed p\u0159i vagin\u00e1ln\u00edm porodu a bezprost\u0159edn\u011b po n\u011bm kolonizuj\u00ed za\u017e\u00edvac\u00ed trakt a k\u016f\u017ei novorozence.
\nP\u0159irozen\u00fd rozvoj pestr\u00e9ho mikrobiomu hraje v\u00fdznamnou \u00falohu v cel\u00e9 \u0159ad\u011b fyziologick\u00fdch proces\u016f souvisej\u00edc\u00edch zejm\u00e9na se zdrav\u00fdm rozvojem imunitn\u00edho syst\u00e9mu. Naru\u0161en\u00ed v\u00fdvoje mikrobiomu m\u016f\u017ee v\u00e9st k naru\u0161en\u00ed z\u00e1sadn\u00edch regula\u010dn\u00edch proces\u016f organismu a t\u00edm podpo\u0159it vznik cel\u00e9 \u0159ady chorob. Tyto skute\u010dnost by si m\u011bly uv\u011bdomovat zejm\u00e9na rodi\u010dky, kter\u00e9 se rozhoduj\u00ed o proveden\u00ed c\u00edsa\u0159sk\u00e9ho \u0159ezu bez jasn\u00e9 zdravotn\u00ed indikace. <\/p>\n

V posledn\u00ed dob\u011b se objevil kontroverzn\u00ed n\u00e1zor (velmi ojedin\u011bl\u00fd, respektive jednoho pracovi\u0161t\u011b), a to, \u017ee by m\u011blo existovat pr\u00e1vo \u017eeny, aby si vy\u017e\u00e1dala na p\u0159\u00e1n\u00ed c\u00edsa\u0159sk\u00fd \u0159ez. \u017deny si nej\u010dast\u011bji p\u0159ej\u00ed vyhnout se p\u0159irozen\u00e9mu, vagin\u00e1ln\u00edm porodu, proto\u017ee se boj\u00ed porodn\u00edch bolest\u00ed. Zm\u00edn\u011bn\u00fd n\u00e1zor, \u017ee je t\u0159eba \u017een\u00e1m vyhov\u011bt, nebo dokonce je nab\u00e1dat k c\u00edsa\u0159sk\u00e9mu \u0159ezu je op\u0159en o riziko poran\u011bn\u00ed p\u00e1nevn\u00edho dna rodi\u010dky pr\u016fchodem plodu porodn\u00edmu cestami. Tyto komplikace sice hroz\u00ed, ale zejm\u00e9na u star\u0161\u00edch \u017een, a to je\u0161t\u011b ne u v\u0161ech.<\/p>\n

T\u011blo t\u011bhotn\u00e9 je na bolest dob\u0159e p\u0159ipraven\u00e9. \u017dena jen pot\u0159ebuje dostatek informac\u00ed<\/strong><\/p>\n

Pr\u00e1v\u011b proto, \u017ee pom\u011brn\u011b \u010dast\u00fdm probl\u00e9mem t\u011bhotn\u00fdch \u017een je strach z porodn\u00edch bolest\u00ed, je t\u0159eba jim vysv\u011btlit, \u017ee bolest je z\u00e1kladn\u00ed vlastnost vagin\u00e1ln\u00edho porodu. Dnes v\u00edme pro\u010d bolest u porodu nast\u00e1v\u00e1. Tak\u00e9 je zn\u00e1mo, \u017ee t\u011blo t\u011bhotn\u00e9 je na bolest fyziologicky p\u0159ipraveno (\u017eena m\u00e1 vy\u0161\u0161\u00ed pr\u00e1h bolesti, ne\u017e p\u0159ed ot\u011bhotn\u011bn\u00edm). Je proto velk\u00e1 nad\u011bje, \u017ee bolest zvl\u00e1dne \u017eena sama. Pokud nebude z\u00e1t\u011b\u017e zvl\u00e1dat, mohou j\u00ed b\u00fdt poskytnuty prost\u0159edky na tlumen\u00ed bolesti. Tyto prost\u0159edky a metody pro tlumen\u00ed porodn\u00edch bolest\u00ed jsou dnes zcela bezpe\u010dn\u00e9.<\/p>\n

role v uklidn\u011bn\u00ed t\u011bhotn\u00fdch \u017een spo\u010d\u00edv\u00e1 na bedrech porodn\u00edch asistentek v kurzech p\u0159edporodn\u00ed p\u0159\u00edpravy. Na \u017e\u00e1dost \u010cesk\u00e9 spole\u010dnosti porodn\u00edch asistentek t\u00fdm l\u00e9ka\u0159\u016f a porodn\u00edch asistentek z 1. l\u00e9ka\u0159sk\u00e9 fakulty Univerzity Karlovy a V\u0161eobecn\u00e9 fakultn\u00ed nemocnice v Praze (porodnice \u201eU Apolin\u00e1\u0159e\u201c) p\u0159ipravil unik\u00e1tn\u00ed program pro porodn\u00ed asistentky z cel\u00e9 \u010cesk\u00e9 republiky \u201eJak nau\u010dit u\u010dit\u201c. \u201ePomoc\u00ed dne\u0161n\u00edch informa\u010dn\u00edch technologi\u00ed je mo\u017en\u00e9, aby porodn\u00ed asistentky, kter\u00e9 tento program absolvuj\u00ed, z\u00edskaly dovednosti jak t\u011bhotn\u00e9 p\u0159esn\u011b a objektivn\u011b informovat. Pro tyto \u00fa\u010dely bylo v porodnici \u201eU Apolin\u00e1\u0159e\u201c vybudov\u00e1no centrum (AVE Centrum) za p\u0159isp\u011bn\u00ed Avent Phillips prost\u0159ednictv\u00edm Nada\u010dn\u00edho fondu VITA et FUTURA, kter\u00e9 se pr\u00e1v\u011b dnes otev\u00edr\u00e1,\u201c vysv\u011btluje prof. Pa\u0159\u00edzek.<\/p>\n

Porodn\u00ed asistentky se zde budou vzd\u011bl\u00e1vat v r\u016fzn\u00fdch dovednostech, mimo jin\u00e9 i v tom, jak informovat ve\u0159ejnost, \u017ee c\u00edsa\u0159sk\u00fd \u0159ez se m\u00e1 prov\u00e1d\u011bt jen v p\u0159\u00edpad\u011b rizika ohro\u017een\u00ed zdrav\u00ed matky a\/nebo d\u00edt\u011bte. Budou muset um\u011bt vysv\u011btlit, \u017ee je sice c\u00edsa\u0159sk\u00fd \u0159ez z hlediska matky dnes bezpe\u010dn\u00e1 operace, \u017ee m\u00e1me bezpe\u010dnou anestezii (region\u00e1ln\u00ed) a bezpe\u010dn\u00e9 opera\u010dn\u00ed techniky, ale \u017ee existuj\u00ed kr\u00e1tkodob\u00e9 ale i dlouhodob\u00e9 v\u00fdsledky u d\u011bt\u00ed porozen\u00fdch c\u00edsa\u0159sk\u00fdm \u0159ezem, a ty tak pozitivn\u00ed nejsou.<\/p>\n

C\u00edsa\u0159sk\u00fd \u0159ez m\u016f\u017ee b\u00fdt nenahraditeln\u00fdm, \u017eivot a zdrav\u00ed zachra\u0148uj\u00edc\u00edm v\u00fdkonem, tam kde je akutn\u011b ohro\u017een plod \u010di matka, nebo v p\u0159\u00edpadech kde vagin\u00e1ln\u00ed porod p\u0159edstavuje p\u0159\u00edli\u0161 vysok\u00e9 riziko.<\/p>\n

C\u00edsa\u0159sk\u00fdch \u0159ez\u016f bylo 24,9 %, co\u017e znamen\u00e1, \u017ee jejich po\u010det poklesl a jsme pod pr\u016fm\u011brem zem\u00ed EU (medi\u00e1n \u010din\u00ed 25,2 %). Tento pokles byl v\u011bt\u0161inov\u011b \u010desk\u00fdmi odborn\u00edky velmi pozitivn\u011b p\u0159ijat. O tom sv\u011bd\u010d\u00ed ohlasy z kongresu v dubnu 2017 v Karlov\u00fdch Varech. \u201eV\u00fdsledky jsou tedy impozantn\u00ed a \u0159ad\u00ed na\u0161\u00ed zemi z hlediska p\u00e9\u010de o matku a d\u00edt\u011b mezi nejlep\u0161\u00ed st\u00e1ty sv\u011bta. \u00dakol dne\u0161n\u00edho porodnictv\u00ed, respektive perinatologie je tyto v\u00fdsledky a \u00farove\u0148 udr\u017eet,\u201c komentuje prof. MUDr. Anton\u00edn Pa\u0159\u00edzek, CSc., vedouc\u00ed l\u00e9ka\u0159 Perinatologick\u00e9ho centra Gynekologicko-porodnick\u00e9 kliniky 1. l\u00e9ka\u0159sk\u00e9 fakulty UK a VFN v Praze. <\/p>\n","protected":false},"excerpt":{"rendered":"

C\u00edsa\u0159sk\u00fd \u0159ez z hlediska matky dnes bezpe\u010dn\u00e1 operace, ale existuj\u00ed kr\u00e1tkodob\u00e9 ale i dlouhodob\u00e9 v\u00fdsledky u d\u011bt\u00ed porozen\u00fdch c\u00edsa\u0159sk\u00fdm \u0159ezem, a ty tak pozitivn\u00ed nejsou.<\/p>\n<\/div>","protected":false},"author":1,"featured_media":24479,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-29772","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/29772","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=29772"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/29772\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/24479"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29772"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29772"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29772"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}