Dangane da ma’anar WHO, haihuwar da ba a haifa ba ita ce “mutuwar samfur na ɗaukar ciki lokacin da wannan mutuwar ta faru kafin korar ko fitar da cikakkiyar jikin mahaifiyar, ba tare da la’akari da tsawon lokacin yin ciki ba. An nuna mutuwa ?? ta hanyar cewa bayan wannan rabuwa, tayin ba ya numfashi ko bayyana wani alamar rayuwa kamar bugun zuciya, bugun mahaifa ko ƙuntataccen ƙwayar tsoka da aka yi da nufin so ”. Hukumar ta WHO ta kuma bayyana kofa mai yiwuwa: makonni 22 na amenorrhea (WA) da aka kammala ko nauyin 500 g. Muna magana akan mutuwar tayi a cikin utero (MFIU) lokacin da aka lura da mutuwa ?? kafin fara haihuwa, sabanin mutuwar mahaifa, wanda ke faruwa sakamakon mutuwa yayin haihuwa.

Tare da haihuwar yara 9,2 na yara marasa rai a cikin haihuwar 1000, Faransa tana da mafi yawan haihuwa a Turai, yana nuna rahoton Turai kan lafiyar mahaifa EURO-PERISTAT na 2013 (1). A cikin sanarwar manema labarai (2) da ke da alaƙa da waɗannan sakamakon, Inserm ya baiyana, duk da haka, cewa ana iya yin bayanin wannan adadi mai yawa ta hanyar cewa 40 zuwa 50% na mutuwar haihuwa a Faransa suna da alaƙa da ƙarshen likita na ciki (IMG), wannan saboda "Manufa ce mai ƙarfi na nunawa don abubuwan da ba a haifa ba da kuma ƙarancin aikin IMG". Daga makonni 22, a zahiri ana aiwatar da kisan kai a gaban IMG don gujewa wahalar da tayi. Don haka IMG yana haifar da haƙiƙa zuwa haihuwar ɗan “wanda bai mutu ba”.

RHEOP (Rijistar Ƙarancin Ƙananan Yara da Kulawa da Haihuwa) (3), wanda ke lissafa mutuwar haihuwa a Isère, Savoie da Haute-Savoie, don shekarar 2011 ta ba da rahoton adadin mutuwar 7,3, 3,4 ‰, gami da 3,9 ‰ don rashin haihuwa (MFIU) da XNUMX ‰ don haifar da mutuwar haihuwa (IMG).

Don ƙoƙarin bayyana abin da ke haifar da mutuwar tayin a cikin mahaifa, ana aiwatar da kima cikin tsari. Ya ƙunshi aƙalla (4):

• histological jarrabawa na mahaifa;
• autopsy na tayin (bayan izinin mai haƙuri);
• gwajin Kleihauer (gwajin jini don auna adadin jajayen ƙwayoyin jinin da tayi a tsakanin jajayen jinin mahaifa);
• bincike don agglutinins marasa tsari;
• serologies na mahaifa (parvovirus B19, toxoplasmosis);
• cervico-farji da placental cututtuka swabs;
• neman cutar antiphospholipid antibody syndrome, systemic lupus, type 1 ko 2 diabetes, dysthyroidism.

Mafi yawan sanadin MFIU sune:

• Ancaly-vasculo-placental anomaly: retro-placental hematoma, toxemia, pre-eclampsia, eclampsia, ciwon HELLP, zub da jini na uwa, precenta previa da sauran abubuwan da ke haifar da shigar mahaifa;
• ilimin cututtukan appendages: igiya (fitowar igiya, igiya a wuyanta, ƙulli, sakawa, wanda ke nufin igiyar da aka saka akan membranes ba mahaifa ba), ruwan amniotic (oligoamnios, hydramnios, rupture of membranes);
• rashin daidaiton tayi na tsarin mulki: anomaly congenital, autoimmune hydrops edema (edema gabaɗaya), ciwon transfusion-transfused syndrome, wanda aka jinkirta;
• raunin ci gaban intrauterine;
• wani kamuwa da cuta: chorioamniotic, cytomegalovirus, toxoplasmosis;
• ilimin mahaifa: ciwon sukari da ba a riga an tabbatar da shi ba, cututtukan thyroid, mahimmancin hauhawar jini, lupus, cholestasis na ciki, amfani da miyagun ƙwayoyi, ilimin mahaifa (tarihin fashewar mahaifa, nakasawa, septum na mahaifa), ciwon antiphospholipid;
• rauni na waje yayin daukar ciki;
• shakar numfashi ko rauni yayin haihuwa.

A cikin 46% na lokuta, mutuwar tayi ba a bayyana ta ba, duk da haka, ta ƙayyade RHEOP (5).

Bayan ganewar mutuwar tayi a cikin mahaifa, ana ba da magani ga mahaifiyar da za ta haifa don haifar da aiki. Fitar da jaririn ta hanyar farji koyaushe ana fifita shi zuwa sashen tiyata.

Hakanan ana samun tallafin ilimin halin ɗabi'a don taimakawa ma'aurata su sami rauni ta hanyar ɓacin rai. Wannan tallafin yana farawa da zaran an sanar da mutuwar jaririn, gami da zaɓin kalmomi. Ana ba iyaye shawara tare da ungozoma da ta ƙware a cikin ɓacin rai ko kuma masanin ilimin halayyar ɗan adam. Shin suna son ganin jaririn, ɗaukar shi, yi masa sutura, ko ba sa masa suna? Ya rage ga iyaye su yanke waɗannan shawarwarin waɗanda wani bangare ne na tsarin baƙin cikin su. Ma'auratan kuma suna da kwanaki 10 bayan haihuwa don zaɓar yiwa ɗansu jana'iza da jana'iza, ko kuma ɗaukar gawar zuwa asibiti don ƙonawa.

Bakin ciki na zaman makoki guda ɗaya ne: na mutumin da bai rayu ba, sai a cikin mahaifiyarsa. Dangane da binciken Amurka (6), haɗarin ɓacin rai bayan ɗan da ba a haifa ba zai iya jurewa har zuwa shekaru 3 bayan haihuwa. Sabili da haka ana ba da shawarar bin diddigin ilimin halin ɗabi'a, kamar yadda ake neman tallafi daga ƙungiyoyin tallafi da ƙungiyoyi.

Tunanin "yaron da aka haifa ba tare da rai ba" ya bayyana a karon farko a dokar Faransa a 1993. Tun daga wannan lokacin, dokar ta ɓullo a lokuta da dama. Kafin doka n ° 2008-800 na 20 ga Agusta, 2008, tayin daya wuce mako 22 ya wanzu dangane da matsayin farar hula. Daga yanzu, ana iya ba da takardar shaidar haihuwa. kafin 22 SA (amma gaba ɗaya bayan 15 SA) bisa buƙatun iyaye. Bayan wannan lokacin, ana bayar da shi ta atomatik.

Wannan takaddar ta ba da damar kafa “aikin yaro neÌ ?? ba tare da rayuwa ba ”wanda ke ba iyaye damar, idan suna so, sanya sunan farko ko biyu ga ɗansu da sanya shi cikin littafin rikodin danginsu, ko kafa ɗaya idan ba su da ɗaya. tukuna. A gefe guda kuma, ba za a iya ba da sunan dangi ko mahaɗin haɗin gwiwa ga wannan ɗan da ba a haifa ba; saboda haka ba mutum bane na shari'a. A alamance, duk da haka, wannan dokar tana nuna ci gaba don karɓar yaran da suka mutu a matsayin mutum, sabili da baƙin ciki da wahala da ke kewaye da su. Hakanan ma'aurata ne don sanin matsayin su na "iyaye".

Idan ta haihu kafin makonni 22, matar ba za ta iya amfana da hutun haihuwa ba. Likita na iya, duk da haka, ya ba shi dakatarwar aiki yana ba shi haƙƙin diyya daga Inshorar Lafiya.

Idan ta haihu bayan makonni 22, matar tana cin gajiyar cikakkiyar hutun haihuwa. Hakanan za a yi la’akari da wannan ciki ta tsaro ta zamantakewa lokacin lissafin hutun haihuwa na gaba.

Mahaifin zai iya amfana daga alawus na izinin haihuwa na yau da kullun, a kan gabatar da kwafin aikin mara rai da takardar shaidar likitanci na haihuwar yaron da aka haifa matacce.

Iyaye za su iya amfana daga kariyar haihuwa (bisa albarkatu) kawai idan ƙarshen ciki ya faru daga ranar 1 ga watan da ke biyo bayan watan 5 na ciki. Sannan ya zama dole a samar da shaidar ciki a wannan ranar.

Dangane da haraji, an yarda cewa yaran da har yanzu aka haife su a cikin shekarar haraji kuma waɗanda suka haife wurin aÌ € kafa wani aiki na ne yaro ?? ana amfani da marasa rai don tantance adadin raka'a.