Перинатальные Инфекции

3

: \ l h j u

^ f g0; HoZidbg d f g F < Obljh\ B G Bevyr_gdh

dZn_^jZ Zdmr_jkl\Z b ]bg_dheh]bb YjhkeZ\kdhc =hkm^Zjkl\_gghc f_^bpbgkdhc ZdZ^_fbb aZ\ dZn ijhn F ; HoZidbg.

J _ p _ g a _ g l

^hp_gl < I Dbk_e_\ aZ\_^mxsbc dZn_^jhc ^_lkdbo bgn_dpbhgguo [he_ag_c i_^bZljbq_kdh]h nZdmevl_lZ Y=F:

F_lh^bq_kdh_ ihkh[b_ ml\_j`^_gh F_lh^bq_kdhc dhfbkkb_c ih ihke_^biehfghfm h[jZah\Zgbx YjhkeZ\kdhc =hkm^Zjkl\_gghc f_^bpbgkdhc ZdZ^_fbb

H=E:<E?GB?

GZbf_gh\Zgb_ jZa^_eZ klj

4

<BJMKU I. DjZkgmoZ

DjZkgmoZ jm[_eeZ g_f_pdZy dhjv hlghkblky d \ha^mrgh dZi_evguf bgn_dpbyf b i_j_^Z_lky q_j_a ghkh ]ehlhqguc k_dj_l Ohly wlh aZ[he_\Zgb_ oZjZdl_jgh ^ey ^_lkdh]h \hajZklZ gh [he__ iheh\bgu \k_o aZ[he_\rbo \ ihke_^gb_ ]h^u ijboh^blky gZ \hajZkl [he__ e_l Z \ \hajZkl_ e_l aZ[he_\Zxl iZpb_glh\ \ \hajZkl_

e_l beb klZjr_ D j_ijh^mdlb\ghfm \hajZklm `_gsbg iheh\bgZ \ km[debgbq_kdhc nhjf_ m`_ [he_eb djZkgmohc b bf_xl ih`bag_gguc bffmgbl_l d wlhfm aZ[he_\Zgbx

<ZdpbgZpby ijhlb\ djZkgmob [ueZ \\_^_gZ k ] b _z qZklhlZ agZqbl_evgh kgbabeZkv ^h gZk_e_gby ih ^Zgguf KR: Ijh[e_fhc y\ey_lky aZ[he_\Z_fhklv D [_j_f_gguo \ jZggbo kjhdZo Jbkd mjh^kl\ m ieh^Z ijb aZ[he_\Zgbb fZl_jb \,ljbf_klj_ [_j_f_gghklb khklZ\ey_l hdheh ^h

gZ f_kyp_ b gZ _f f_kyp_ [_j_f_gghklb <hafh`gufb mjh^kl\Zfb y\eyxlky dZlZjZdlZ hldjuluc Zjl_jbZevguc ijhlhd ]emohlZ q_j_a g_kdhevdh e_l \hafh`gh aZ[he_\Zgb_ kZoZjguf ^bZ[_lhf

<bjmk \u^_ey_lky ba djh\b b ]ehldb q_j_a ^g_c ihke_ aZjZ`_gby b _]h \u^_e_gb_ ijh^he`Z_lky hdheh g_^_eb AZ[he_\Zgb_ khijh\h`^Z_lky kuivx dhlhjZy gZqbgZ_lky k ebpZ gZ ^_gv ihke_ aZjZ`_gby ZjljZe]byfb ebfnhZ^_ghiZlb_c ih\ur_gb_f l_fi_jZlmju l_eZ Gh ^ey ^bZ]ghaZ aZ[he_\Zgby gZebqby debgbq_kdhc dZjlbgu g_^hklZlhqgh >ey ih^l\_j`^_gby bgn_dpbb bkihevamxlky jZaebqgu_ k_jheh]bq_kdb_ l_klu

J_Zdpby lhjfh`_gby ]_fZ]]exlbgZpbb Zglbl_eZ ,J * Hl ^h

i_j_[he_\rbo D bf_xl Zglbl_eZ \ \ukhdbo lbljZo < lh `_ \j_fy ^hdZaZl_evkl\hf bffmgbl_lZ d D y\ey_lky lblj Ih^t_f lbljZ Zglbl_e d D ijb ih\lhjghf l_kl_ \ jZaZ b [he__ k\b^_l_evkl\m_l h[ hkljhc bgn_dpbb < ihke_^gb_ ]h^u lhjfh`_gb_ ]_fZ]]exlbgZpbb aZf_g_gh jy^hf ^jm]bo l_klh\ \\b^m bo [hevr_c lhqghklb b ^_r_\bagu eZl_dk Z]]exlbgZpby nexhj_kpbjmxsb_ Zglbl_eZ iZkkb\gZy ]_fZ]]exlbgZpby ]_fheba \ ]_e_ wgabfgu_ bffmggu_ l_klu Bkke_^h\Zgb_ ki_pbnbqgh]h ^ey D,J 0ih^l\_j`^Z_l©k\_`mxªbgn_dpbx fh`_l bkq_aZlv ba djh\b f_g__ q_f q_j_a g_^_ev

<\_^_gb_ bffmgh]eh[mebgZ * g_ ij_^mij_`^Z_l gb \bj_fbx gb ihke_^mxs__ aZ[he_\Zgb_ gh ebrv kfy]qZ_l _]h kbfilhfu ihwlhfm b g_ j_dhf_g^m_lky ihke_ dhglZdlZ k aZ[he_\rbf D dZd jmlbggZy ijhp_^mjZ Lhevdh ^ey `_gsbg hldZaZ\rboky ij_j\Zlv [_j_f_gghklv \\_^_gb_ ,J * fh`_l [ulv f_jhc ijhnbeZdlbdb bgn_dpbb m ieh^Z

LZ[ebpZ Jbkd bgnbpbjh\Zgby ieh^Z

J_a_j\mZjhf bgn_dpbb y\eyxlky ^_lb ^hrdhevgh]h b feZ^r_]h rdhevgh]h \hajZklZ <ZdpbgZpby `b\hc \Zdpbghc ijb\h^bl d ihy\e_gbx bffmgghc aZsblu \

kemqZ_\ G_^Z\gh \Zdpbgbjh\Zggu_ ebpZ fh]ml \u^_eylv \bjmk D gh bo dhglZdl k ©qm\kl\bl_evgufbª d \bjmkm [_j_f_ggufb g_ ij_^klZ\ey_l ^ey gbo hiZkghklb @_gsbg qm\kl\bl_evguo d \bjmkm [_a Zglbl_e j_dhf_g^m_lky \Zdpbgbjh\Zlv ijb wlhf `_eZl_evgh hleh`blv [_j_f_gghklv gZ ^g_c ?keb \k_ `_ \ZdpbgZ \\_^_gZ ijb [_j_f_gghklb \ i_j\u_ _z f_kypZ \bjmk \ ldZgyo ieh^Z h[gZjm`b\Z_lky lhevdh \

5

kemqZ_\ b g_ \uau\Z_l mjh^kl\ <ZdpbgZpby \hafh`gZ \ jZggbc ihke_jh^h\uc i_jbh^ b g_ y\ey_lky ij_iylkl\b_f ^ey ]jm^gh]h \kZjfeb\Zgby G_ j_dhf_g^mxl \ZdpbgZpbx ijb ih\ur_gbb l_fi_jZlmju l_eZ b ijb bffmghkmij_kkbb

II. Pblhf_]Zeby.

<ha[m^bl_ev >GD kh^_j`Zsbc \bjmk hlghkysbcky d ]jmii_ \bjmkh\ ]_ji_kZ < gZklhys__ \j_fy kqblZ_lky gZb[he__ qZklhc ijbqbghc \gmljbmljh[ghc bgn_dpbb Ih kh\j_f_gguf ^Zgguf \k_o gh\hjh`^_gguo bf_xl \bjmk ijb jh`^_gbb b _s_

\k_o gh\hjh`^_gguo ihemqZxl _]h \ i_jbgZlZevguc i_jbh^ L_jZlh]_gguc ihl_gpbZe g_ mklZgh\e_g Mjh^kl\Z lZdb_ dZd dZlZjZdlZ beb ihjhdb k_j^pZ \klj_qZxlky j_^dh OZjZdl_jgu_ ^ey aZ[he_\Zgby djmigu_ de_ldb k y^jZfb kh^_j`Zsbfb \dexq_gby l g kbfilhf ©kh\bguo ]eZaª iZlh]ghfhgbqguc gh j_^dh \klj_qZxsbcky m bgnbpbjh\Zgguo ebp ba\_klgu k gZqZeZ \_dZ gh kZf \bjmk \u^_e_g ebrv \ ] Ihke_ \u^_e_gby dmevlmju \bjmkZ mklZgh\e_gh qlh [hevrbgkl\h kemqZ_\ bgnbpbjh\Zgby ijhl_dZ_l [_a debgbq_kdbo ijhy\e_gbc

Wib^_fbheh]by Qm\kl\bl_evgufb d bgnbpbjh\Zgbx PF< d k\h_fm j_ijh^mdlb\ghfm \hajZklm hklZxlky hdheh `_gsbg `_gsbg k \ukhdbf khpbZevgh wdhghfbq_kdbf klZlmkhf b k gbadbf GZb[hevrZy k_jhdhg\_jkby hlf_qZ_lky \ \hajZkl_ e_l ?`_]h^gh `_gsbg k \ukhdbf KWK b k gbadbf bgnbpbjmxlky PF<

NZdlhjZfb jbkdZ PF< bgn_dpbb y\eyxlky gbadbc KWK ih\lhjgu_ [_j_f_gghklb klZjrbc \hajZkl i_j\Zy [_j_f_gghklv ^h e_l b qbkeh iheh\uo iZjlg_jh\ Hlkmlkl\b_ nZdlhjh\ jbkdZ ih\urZ_l \_jhylghklv bgnbpbjh\Zgby PF< ijb [_j_f_gghklb [_j_f_gguo ©qm\kl\bl_evguoª d PF< bgnbpbjmxlky \h \j_fy [_j_f_gghklb DhglZ]bhaghklv PF< g_\ukhdZ ihwlhfm ^ey aZjZ`_gby gm`_g l_kguc dhglZdl k ghkbl_e_f \bjmkZ iheh\hc [ulh\hc ^_lb >_lb ihk_sZxsb_ ^hrdhevgu_ mqj_`^_gby bgnbpbjmxlky \ b \u^_eyxl \bjmk hdheh e_l ihke_ aZjZ`_gby ?keb h^bg ba qe_gh\ k_fvb bgnbpbjm_lky PF< hg aZjZ`Z_l iheh\bgm qe_gh\ k_fvb

< kemqZ_\ bgn_dpby m \ajhkeuo ijhl_dZ_l km[debgbq_kdb gh \

ihy\ey_lky kbfilhfZlbdZ koh^gZy k fhghgmde_hahf e_cdh ebfnhpblha gZjmr_gby nmgdpbb i_q_gb ]_dlbq_kdZy ebohjZ^dZ g_^hfh]Zgb_ g_ \klj_qZxlky ]_iZlhkie_ghf_]Zebyb `_elmoZ K_jv_agu_ hkeh`g_gby bgn_dpbb m \ajhkeuo j_^db b gZ[ex^Zxlky ebrv ijb khklhygbb bffmgh^_nbpblZ beb ijb f_^bdZf_glhaghc bffmghkmij_kkbb [he__ \_jhylgu hgb ^ey ieh^Z hkh[_ggh k gbadhc fZkkhc ijb jh`^_gbb f_g__ M aZ[he_\rbo \bjmk ihklhyggh \u^_ey_lky \h \g_rgxx kj_^m b fh`_l ^ebl_evgh ij_^klZ\eylv hiZkghklv ^ey aZjZ`_gby ijb \gmljbmljh[ghf aZjZ`_gbb ]h^Z ijb aZjZ`_gbb \ jh^Zo ]h^Z m \ajhkeuo \u^_ey_lky i_jbh^bq_kdbj_bgn_dpby j_Zdlb\Zpby khklhygby bffmghkmij_kkbb ;_j_f_ggu_ k [_kkbfilhfgh ijhl_dZxs_c bgn_dpb_c \u^_eyxl \bjmk r_cdZ fZldb fhq_\u\h^ysb_ imlb

]jm^gh_ fhehdh ^h ]ehldZ \ p_ehf QZklhlZ \u^_e_gby \bjmkZ gZjZklZ_l k l_q_gb_f [_j_f_gghklb \ ljbf_klj_ \ ljbf_klj_

Ijb wlhf kh^_j`Zgb_ \ djh\b Zglbl_e d PF< hklZ_lky ihklhygguf

<gmljbmljh[gh_ bgnbpbjh\Zgb_ PF< h[uqgh ijhbkoh^bl ljZgkieZp_glZjgh ohly \hafh`gZ b \hkoh^ysZy bgn_dpby ba r_cdb fZldb Hdheh

\k_o gh\hjh`^_gguo ijb jh`^_gbb \u^_eyxl PF< qZs_ ba fhqb ?s_

\k_o gh\hjh`^_gguo ihemqZxl PF< \h \j_fy jh^h\ b iha`_ r__qguc k_dj_l ljZgkieZp_glZjgZy ljZgknmaby fZl_jbgkdh_ fhehdh Ijb gZebqbb m fZl_jb PF< bgn_dpbb \ iheh\uo imlyo gZ fhf_gl jh^h\ gh\hjh`^_gguo [m^ml bgnbpbjh\Zgu Ijb gZebqbb PF< \ fhehd_ fZl_jb gh\hjh`^_gguo [m^ml bgnbpbjh\Zgu \ l_q_gb_ f_kyp_\

6

Ijb gZebqbb m fZl_jb Zglbl_e d PF< \jh`^_ggh_ bgnbpbjh\Zgb_ hlf_qZ_lky m

gh\hjh`^_gguo Ijb bgnbpbjh\Zgbb fZl_jb PF< \i_j\u_ \ i_jbh^ [_j_f_gghklb \gmljbmljh[gh bgnbpbjmxlky ^h ieh^h\ qZs_ \klj_qZxlky hkeh`g_gby ^ey gh\hjh`^_ggh]h ijhlb\ g_cjh k_gkhjgu_ gZjmr_gby debgbq_kdZy kbfilhfZlbdZ bgn_dpbb aZ^_j`dZ mfkl\_ggh]h jZa\blby ^\mklhjhggyy ihl_jy kemoZ

G_kfhljy gZ \ukhdmx qZklhlm PF< m fZl_jb m ieh^Z b gh\hjh`^_ggh]h mjh\_gv bgnbpbjh\Zgghklb gb`_ \ jZaZ GZb[he__ ly`_eu_ ihke_^kl\by \jh`^_gghc PF< bgn_dpbb gZ[ex^Zxlky ijb aZjZ`_gbb ieh^Z \ b ljbf_kljZo [_j_f_gghklb Ijb _]h aZjZ`_gbb \ ljbf_klj_ gh\hjh`^_gguc g_ bf__l kbfilhfh\ bgn_dpbb gh \ _]h ku\hjhld_ djh\b h[gZjm`b\Z_lky ,J 0 Hlkmlkl\b_ kbfilhfh\ bgn_dpbb ijb jh`^_gbb _sz g_ hagZqZ_l ^Zevg_cr_]h [eZ]hihemqby ihklhygguc b ijh]j_kkbjmxsbc oZjZdl_j bgn_dpbb fh`_l ijb\_klb d iZlheh]bb PGK b g_\jheh]bq_kdbf hkeh`g_gbyf ij_^klZ\eyxsbf ]eZ\gu_ ihke_^kl\by bgn_dpbb

Ijb gZebqbb kbfilhfh\ PF< ijbf_jgh bgnbpbjh\Zgguo m gh\hjh`^_ggh]h kf_jlghklv ^hklb]Z_l Z \u`b\rbo gh\hjh`^_gguo bf_xl iha^gb_ hkeh`g_gby aZ[he_\Zgby km^hjh]b kiZklbq_kdZy ^bie_]by Zljhnby ajbl_evgh]h g_j\Z ke_ihlZ ]emohlZ hlklZ\Zgb_ \ mfkl\_gghf jZa\blbb Gh b m bgnbpbjh\Zgguo gh\hjh`^_gguo [_a kbfilhfh\ aZ[he_\Zgby lZd`_ \hafh`gu iha^gb_ hkeh`g_gby hlklZ\Zgb_ \ mfkl\_gghf jZa\blbb fbdjhp_nZeby beb ]b^jhp_nZeby ]emohlZ ohj_hj_lbgbl gh agZqbl_evgh j_`_ M iheh\bgu gh\hjh`^_gguo k kbfilhfZlbdhc aZ[he_\Zgby hgZ y\ey_lky lbibqghc ohly b gZihfbgZ_l ijhy\e_gby ^jm]bo ba\_klguo bgn_dpbc ]_iZlhkie_ghf_]Zeby `_elmoZ ljhf[hpblhi_gbq_kdZy imjimjZ fbdjhp_nZeby ]emohlZ ohj_hj_lbgbl Zljhnby ajbl_evgh]h g_j\Z dZevpbgZlu ldZgb fha]Z i_jb\_gljbdmeyjgu_ beb \ km[wi_g^bfZevghc ahg_ aZ^_j`dZ jhklZ

>bZ]gha bgnbpbjh\Zgguf PF< [_j_f_gguf dZd ijZ\beh g_ klZ\blky \\b^m hlkmlkl\by debgbdb aZ[he_\Zgby >ey ih^l\_j`^_gby ^bZ]ghaZ bkihevamxlky k_jheh]bq_kdb_ f_lh^u g_ijyfZy ]_fZ]]exlbgZpby g_ijyfZy bffmghnemhj_kp_gpby bffmghkhj[pby (/,6$ ^_fhgkljbjmxsb_ gZebqb_ k_jhdhg\_jkbb LZd dZd ih f_gvr_c f_j_ hdheh \ajhkeuo bf_xl Zglbl_eZ d PF< _^bgbqguc j_amevlZl g_ mdZau\Z_l gZ ZdlmZevghklv bgn_dpbb ^Z\gyy beb ©k\_`Zyª hkljZy GZebqb_ ki_pbnbq_kdh]h ,J 0 mdZau\Z_l gZ aZjZ`_gb_ \ [eb`Zcrb_ f_kyp_\ Baheypby \bjmkZ \ dmevlmj_ fh`_l ihlj_[h\Zlv hl ^h g_^_ev g_ jZaebqZ_l i_j\bqgmx b \ha\jZlgmx bgn_dpbx gh \u^_e_gb_ \bjmkZ ba fhqb beb r_cdb fZldb ih^l\_j`^Z_l [_kkbfilhfgh_ \bjmkhghkbl_evkl\h l d ijb \ha\jZlghc bgn_dpbb mjh\_gv Zglbl_e \ hj]Zgbaf_ [hevgh]h g_ f_gy_lky

M gh\hjh`^_gguo debgbq_kdb_ ijhy\e_gby PF< bgn_dpbb \\b^m bo g_ki_pbnbqghklb g_ y\eyxlky ^hklZlhqgufb ^ey ^bZ]ghaZ aZ[he_\Zgby ^ey ihklZgh\db dhlhjh]h lj_[mxlky eZ[hjZlhjgu_ bkke_^h\Zgby K_jheh]bq_kdb_ l_klu jZkkfZljb\Zxlky dZd \kihfh]Zl_evgu_ Z gZb[he__ lhqguf kqblZ_lky baheypby \bjmkZ \ dmevlmj_ de_lhd FZl_jbZe ^ey bkke_^h\Zgby fh`_l [ulv ihemq_g ba fhqb ghkh]ehldb dhgtxgdlb\u kibghfha]h\hc `b^dhklb

Ij_gZlZevguc ^bZ]gha \hafh`_g k bkihevah\Zgb_f MAB Zfgbhp_gl_aZ dhj^hp_gl_aZ Ijb MAB gZb[he__ qZklh fh`gh h[gZjm`blv fbdjh b ]b^jhp_nZebx dbklhagu_ baf_g_gby beb hqZ]b dZevpbnbdZpbb g_djha \ i_jb\_gljbdmeyjghc ahg_ fha]Z ldZgb i_q_gb ieZp_glu aZ^_j`dm jhklZ ieh^Z fZeh\h^b_ Zkpbl m ieh^Z i_jbdZj^bZevguc beb ie_\jZevguc \uihl ]bihwoh]_gguc dbr_qgbd \h^ygdm ieh^Z < djh\b ieh^Z ihemq_gghc dhj^hp_gl_ahf \hafh`gh hij_^_e_gb_ ih\ur_ggh]h mjh\gy ki_pbnbqgh]h ,J 0 qm\kl\bl_evghklv h[gZjm`_gb_ Zg_fbb ljhf[hpblhi_gbb

7

]bi_j[bebjm[bg_fbb ih\ur_gb_ ljZgkZfbgZa i_q_gb <hafh`gh dmevlb\bjh\Zgb_ :@ dm^Z \bjmk \u^_ey_lky ihqdZfb ieh^Z ijh\_^_gb_ IPJ Ijb hljbpZl_evghf j_amevlZl_ bkke_^h\Zgby gh ijb \ukhdhf jbkd_ bgnbpbjh\Zgby fZl_jb hgh ih\lhjy_lky q_j_a g_^_ev

E_q_gb_ Ki_pbnbq_kdh]h e_q_gby g_ kms_kl\m_l <hafh`gh ijbf_g_gb_ ]Zgpbdeh\bjZ b nhkdZjg_lZ ijb PF< j_lbgbl_ m <BQ bgnbpbjh\Zgguo KIB> <_^_lky jZ[hlZ gZ^ \Zdpbghc l d Zglbl_eZ d PF< ohly b g_ mgbqlh`Zxl \bjmk b g_ bkdexqZxl \gmljbmljh[gh]h aZjZ`_gby m [hevr_c qZklb gh\hjh`^_gguo bgnbpbjh\Zgguo \gmljbmljh[gh fZl_jb bf_eb Zglbl_eZ d PF< \k_ `_ agZqbl_evgh kgb`Zxl jbkd bgn_dpbb b _z ly`_euo ihke_^kl\bc ^ey ieh^Z b gh\hjh`^_ggh]h

Kdjbgbg] gZ PF< bgn_dpbx g_ j_dhf_g^m_lky:

Z ^hjh]h [ [hevrbgkl\h kemqZ_\ \jh`^_gghc PF< bgn_dpbb j_]bkljbjm_lky m `_gsbg k Zglbl_eZfb d \bjmkm \ gZb[he__ \_jhylguc bkoh^ [_j_f_gghklb hkeh`g_gghc PF< bgn_dpb_c jh`^_gb_ ghjfZevgh]h j_[_gdZ

Baheypby PF< bgnbpbjh\Zgguo iZpb_glh\ \ l q b gh\hjh`^_gguo g_ lj_[m_lky G_h[oh^bfh h]jZgbqblvky klZg^Zjlgufb f_jZfb dhgljhey aZ jZkijhkljZg_gb_f bgn_dpbhgguo aZ[he_\Zgbc

III. <Zjbp_eeZ ahkl_j \_ljygdZ

<ha[m^bl_ev >GD kh^_j`Zsbc \bjmk ]jmiiu ]_ji_kZ Hlghkblky d ©^_lkdbfª bgn_dpbyf Hq_gv aZjZa_g gh m [hevrbgkl\Z gZk_e_gby [he__ \klj_qZ_lky ^h j_ijh^mdlb\gh]h \hajZklZ OZjZdl_jgu lbibqgu_ ihjZ`_gby dh`b fZdmeh iZime_agZy kuiv i_j_oh^yrZy \ \_abdme_agmx ^Ze__ \ imklme_agmx k h[jZah\Zgb_f dhjhd b jZkq_kh\ Ijhp_kk kZfhh]jZgbq_g AZ[he_\Zgb_ \ajhkeuo j_Zdlb\Zpby eZl_glghc \bjmkghc bgn_dpbb ijhy\eyxs_cky [he_ag_gghc \_abdme_aghc kuivx ih oh^m g_j\h\ oZjZdl_jgZy ^ey ebp ih`beh]h \hajZklZ b khklhygbc bffmghkmij_kkbb

Imlv jZkijhkljZg_gby \ha^mrgh dZi_evguc ^ey aZjZ`_gby g_h[oh^bf l_kguc dhglZdl Bgdm[Zpbhgguc i_jbh^ ^g_c M ^_l_c ]bi_jl_jfby b kuiv ihy\eyxlky h^gh\j_f_ggh M \ajhkeuo g_^hfh]Zgb_ b ]bi_jl_jfby ihy\eyxlky jZgvr_ kuib gZ g_kdhevdh ^g_c Kuiv gZqbgZ_lky k ebpZ b ]heh\u i_j_oh^bl gZ lmeh\bs_ dhg_qghklb ihjZ`Zxlky j_^dh ?z jZa\blb_ khijh\h`^Z_lky am^hf Gh\u_ \ukuiZgby ihy\eyxlky q_j_a ^g_c \k_ we_f_glu kuib kms_kl\mxl h^gh\j_f_ggh

DhglZ]bhaghklv kmlhd ^h kuib b ^h hliZ^_gby dhjhd Hkeh`g_gby \dexqZxl \lhjbqgmx [Zdl_jbZevgmx bgn_dpbx dh`b Z lZd`_ wgp_nZebl f_gbg]bl fbhdZj^bl ]ehf_jmehg_njbl Zjljbl j_^dh Hq_gv k_jv_aguf hkeh`g_gb_f y\ey_lky ig_\fhgby ih\urZxsZy jbkd kf_jlghklb m \ajhkeuo ^h m ^_l_c j_`_ GZ j_gl]_gh]jZff_ e_]dbo oZjZdl_jgu jZkijhkljZg_ggu_ ma_edh\u_ i_jb[jhgobZevgu_ bgnbevljZlu \hafh`gu ijbagZdb j_kibjZlhjgh]h ^bklj_kkZ

AZ[he_\Z_fhklv kj_^b [_j_f_gguo gbadZ kemqZ_\ gZ ;_j_f_ggu_ [he_xl g_ qZs_ b g_ ly`_e__ g_[_j_f_gguo `_gsbg gh ijb ig_\fhgbb

kf_jlghklv fh`_l ^hklb]Zlv E_q_gb_ ijh\h^blky Zpbdeh\bjhf f] d] \ \ jZaZ \ kmldb ^g_c beb f] jZaSHU RV

M [_j_f_gguo hljbpZxsbo aZ[he_\Zgb_ \_ljygdhc \ ijhrehf h[gZjm`b\Zxlky Zglbl_eZ d \bjmkm < l_o kemqZyo ]^_ ZgZfg_a g_yk_g Zglbl_eZ h[gZjm`b\Zxlky \ Ijb ba\_klghf dhglZdl_ [_j_f_gghc k [hevguf < g_h[oh^bfh hij_^_eblv gZebqb_ Zglbl_e d \bjmkm BN: (/,6$ Ijb bo hlkmlkl\bb g_h[oh^bfh \\_^_gb_ ki_pbnbqgh]h bffmgh]eh[mebgZ \ ij_^_eZo qZkh\ hl bf_\r_]hky dhglZdlZ ?> d] fZkku l_eZ ^h ?> \ f

<i_j\u_ ihjZ`_gb_ ieh^Z ijb aZ[he_\Zgbb [_j_f_gghc < hibkZgu /D)RUHW b /\QFK \ ] Ijb aZ[he_\Zgbb \ jZggbo kjhdZo [_j_f_gghklb hibkZgu Z[hjlu

8

f_jl\hjh`^_gb_ b mjh^kl\Z jm[pu dh`b ]bihieZaby dhg_qghkl_c Zljhnby dhju fha]Z mfkl\_ggZy hlklZehklv aZ^_j`dZ jhklZ fbdjhnlZevfby dZlZjZdlZ Mjh^kl\Z \klj_qZxlky hq_gv j_^dh hdheh gh kf_jlghklv gh\hjh`^_gguo \ wlbo kemqZyo ^hklb]Z_l Bkke_^my jZaebqgu_ qZklb ieh^gh]h ycpZ fh`gh \uy\blv \bjmk < m ieh^Z gh g_\hafh`gh lhqgh mklZgh\blv kl_i_gv _]h ihjZ`_gby HilbfZevguf f_lh^hf hp_gdb \hafh`guo ihke_^kl\bc bgn_dpbb y\ey_lky MAB ^h g_^_ev [_j_f_gghklb ]^_ \hafh`gh \uy\blv gZebqb_ fgh]h\h^by \h^ygdb ieh^Z ]bihwoh]_ggu_ hqZ]b \ i_q_gb ^_nhjfZpbb dhg_qghkl_c qZklh khimlkl\mxsbo ihjZ`_gbx PGK ieh^Z

:glbl_eZ fZl_jb ,J * ^Z`_ _keb k_jhdhg\_jkby bf_eZ f_klh ijb [_j_f_gghklb aZsbsZxl ieh^ GZb[hevrbc jbkd aZ[he_\Zgby gh\hjh`^_ggh]h kms_kl\m_l ijb bgnbpbjh\Zgbb fZl_jb aZ ^gy ^h jh^h\ b \ ij_^_eZo ^g_c ihke_ jh^hjZaj_r_gby Ijb bgnbpbjh\Zgbb fZl_jb aZ ^g_c ^h jh^h\ mjh\_gv \jh`^_gghc bgn_dpbb m gh\hjh`^_gguo khklZ\ey_l Z kf_jlghklv

Ijb bgnbpbjh\Zgbb fZl_jb [he__ q_f aZ ^g_c ^h jh^h\ gh\hjh`^_ggu_ jh`^Zebkv k e_]dbfb nhjfZfb bgn_dpbb beb [_a _z ijhy\e_gbc ?keb jh^u ijb bgnbpbjh\Zgbb [_j_f_gghc g_ m^Z_lky aZ^_j`Zlv gZ ^g_c g_h[oh^bfZ iZkkb\gZy bffmgbaZpby gh\hjh`^_ggh]h g_ihkj_^kl\_ggh ihke_ jh^h\ ?> \ f BffmgbaZpby g_ ij_^hojZgy_l gh\hjh`^_ggh]h hl bgnbpbjh\Zgby ^h bgnbpbjmxlky gh ij_^hl\jZsZ_l e_lZevguc bkoh^ aZ[he_\Zgby Kms_kl\m_l fg_gb_ h g_h[oh^bfhklb bffmgbaZpbb gh\hjh`^_ggh]h ijb bgnbpbjh\Zgbb fZl_jb \ i_jbh^ g_^_eb ^h b ihke_ jh^h\

JZajZ[Zlu\Z_lky \ZdpbgZ ^ey ^_l_c jZgg_]h \hajZklZ ?z ijbf_g_gb_ iha\hebl ihdhgqblv k \bjmkhf < dZd bklhqgbdhf aZ[he_\Z_fhklb ^ey [_j_f_gguo =_ji_k ahkl_j y\eyykv j_Zdlb\Zpb_c eZl_glghc bgn_dpbb ijb gZebqbb Zglbl_e d \bjmkm < g_ ij_^klZ\ey_l m]jhau ^ey a^hjh\vy ieh^Z b gh\hjh`^_ggh]h

IV Dhjv jm[_heZ

<ha[m^bl_ev JGD kh^_j`Zsbc \bjmk hlghkysbcky d iZjZfbdkh\bjmkZf AZ[he_\Zgb_ oZjZdl_jgh ^ey ^_lkdh]h \hajZklZ gZb[he__ aZjZagh kj_^b \k_o ^_lkdbo bgn_dpbc khijh\h`^Zxsboky kuivx Debgbq_kdb_ ijhy\e_gby ]bi_jl_jfby dhgtxgdlb\bl dZr_ev fZdmehiZime_agZy kuiv h[uqgh ihy\eyxsZyky q_j_a ^gy ihke_ ihy\e_gby iZlh]ghfhgbqguo iyl_g DhiebdZ NbeZlh\Z \ ihehklb jlZ I_j_^Z_lky \ha^mrgh dZi_evguf iml_f Bgdm[Zpbhgguc i_jbh^ ^g_c gZb[hevrZy dhglZ]bhaghklv \ i_jbh^ ijh^jhfZ b klZ^bx dZlZjZevguo y\e_gbc aZ[he_\Zxl hl dhglZdlbjh\Z\rbo k [hevguf Ih^t_f aZ[he_\Z_fhklb D bf__l i_jbh^bqghklv \

]h^Z ^h gZqZeZ \ZdpbgZpbb @b\Zy \ZdpbgZ ijhlb\ dhjb ijbf_gy_lky k ] DZd hkeh`g_gby \hafh`gu hlbl djmi wgp_nZebl fbhdZj^bl AZ[he_\Z_fhklv D kj_^b [_j_f_gguo gbadZ >h gZqZeZ \ZdpbgZpbb hgZ khklZ\eyeZ M [_j_f_gguo hkeh`g_gby j_^db gZb[he__ hiZkguf \ hlghr_gbb e_lZevghklb y\ey_lky [Zdl_jbZevgZy ig_\fhgby

>ey ieh^Z jbkd hkeh`g_gbc Z[hjl mjh^kl\Z g_ ^hdZaZg beb hq_gv fZe Ijb gZebqbb debgbq_kdbo ijhy\e_gbc dhjb m gh\hjh`^_ggh]h \ i_j\u_ ^g_c `bagb ke_^m_l kqblZlv bgn_dpbx \jh`^_gghc ijb ihy\e_gbb debgbdb aZ[he_\Zgby gZ

^_gv beb iha`_ ijbh[j_l_gghc ihklgZlZevgh Ijb \jh`^_gghc dhjb kf_jlghklv ^hghr_gguo gh\hjh`^_gguo ^h gZqZeZ ijbf_g_gby Zglb[bhlbdh\ khklZ\eyeZ

g_^hghr_gguo Ijb Zglb[Zdl_jbZevghc l_jZibb b kh\j_f_gguo f_lh^Zo j_ZgbfZpbb kf_jlghklv agZqbl_evgh gb`_

E_q_gb_ ijb g_hkeh`g_gghc D kbfilhfZlbq_kdh_ ijb hlbl_ ig_\fhgbb ke_^m_l gZagZqZlv Zglb[bhlbdb k mq_lhf qm\kl\bl_evghc nehju >ey ijhnbeZdlbdb aZ[he_\Zgby m g_[he_\rbo [_j_f_gguo b gh\hjh`^_gguo ijbf_gy_lky iZkkb\gZy

9

bffmgbaZpby bffmgguc ku\hjhlhqguc ]eh[mebg dhj_\hc \ ^ha_ fe d] fZkku \ i_jbh^ ^g_c hl dhglZdlZ >ey gh\hjh`^_gguo hl fZl_j_c aZ[he_\rbo dhjvx aZg_^_ex ^h beb ihke_ jh^h\ j_dhf_g^m_lky bffmgbaZpby \ lhc `_ ^ha_ Ohly jbkd ^ey ieh^Z kms_kl\m_l ebrv l_hj_lbq_kdb g_ j_dhf_g^m_lky bkihevah\Zlv `b\mx \Zdpbgm ijb [_j_f_gghklb beb \ ij_^_eZo f_kyp_\ ^h aZqZlby fbgbfZevguc i_jbh^ hl \ZdpbgZpbb ^h [_j_f_gghklb f_kyp

V. K\bgdZ.

<ha[m^bl_ev \bjmk lhc `_ ]jmiiu qlh b \ha[m^bl_ev dhjb HkljZy ]_g_jZebah\ZggZy bgn_dpby k ij_bfms_kl\_gguf ihjZ`_gb_f hdhehmrguo b ^jm]bo kexgguo `_e_a djhf_ lh]h fh]ml ihjZ`Zlvky fha] ih^`_em^hqgZy `_e_aZ ]hgZ^u Imlv i_j_^Zqb aZ[he_\Zgby \ha^mrgh dZi_evguc q_j_a dZi_evdb kexgu <bjmk \u^_ey_lky ba kexgu aZ ^g_c ^h gZqZeZ iZjhlblZ b \ l_q_gb_ ^g_c ihke_ Bgdm[Zpbhgguc i_jbh^ ^g_c ;he_xl \ hkgh\ghf ^_lb ^h e_l ihke_ wlh]h \hajZklZ j_]bkljbjmxlky lhevdh kemqZ_\ aZ[he_\Zgby Lj_lv \ajhkeuo bf_xl bffmgbl_l d aZ[he_\Zgbx dZd ke_^kl\b_ debgbq_kdhc beb km[debgbq_kdhc bgn_dpbb K\bgdZ f_g__ aZjZagZ q_f \_ljygdZ beb dhjv gh kj_^b [_j_f_gguo hgZ \klj_qZ_lky

qZs_

Ijh^jhf ijhy\ey_lky \ \b^_ ebohjZ^db g_^hfh]Zgby fbZev]bb Zghj_dkbb Q_j_a

qZkZ ihy\eyxlky y\e_gby iZjhlblZ qZs_ ^\mklhjhgg_]h Ih^q_exklgu_ `_e_au ihjZ`Zxlky j_`_ b \k_]^Z ijb y\e_gbyo iZjhlblZ Ih^tyauqgu_ `_e_au ihjZ`Zxlky j_^dh H[uqgh aZ[he_\Zgb_ g_ ^Z_l hkeh`g_gbc b aZdZgqb\Z_lky kZfhklhyl_evgh Gh baj_^dZ hkeh`g_gby \k_ `_ \hafh`gu hhnhjbl Zk_ilbq_kdbc f_gbg]bl \k_]^Z k [eZ]hijbylgufb bkoh^Zfb Z lZd`_ iZgdj_Zlbl fZklbl lbj_hb^bl fbhdZj^bl g_njbl Zjljbl

M [_j_f_gguo bgn_dpby ijhl_dZ_l e_]dh b g_ hlebqZ_lky hl l_q_gby m g_[_j_f_gguo Ijb aZ[he_\Zgbb iZjhlblhf \ ljbf_klj_ [_j_f_gghklb hlf_q_g jhkl qbkeZ kZfhijhba\hevguo Z[hjlh\ \ jZaZ Mjh\_gv g_^hgZrb\Zgby aZ^_j`db jhklZ ieh^Z i_jbgZlZevghc kf_jlghklb g_ f_gyxlky K\yav aZ[he_\Zgby k wg^hdZj^bZevguf nb[jhweZklhahf gh\hjh`^_gguo k \jh`^_ggufb ZghfZebyfb jZa\blby kqblZ_lky g_ ^hdZaZgghc

>bZ]gha klZ\blky gZ hkgh\Zgbb debgbq_kdbo ijhy\e_gbc ijb g_ykghc debgbq_kdhc dZjlbg_ lj_[m_lky baheypby \bjmkZ beb qZs_ k_jheh]bq_kdb_ l_klu nbdkZpby dhfiebf_glZ lhjfh`_gb_ ]_fZ]]exlbgZpbb lblj g_cljZebamxsbo Zglbl_e \ iZjguo ku\hjhldZo hkljZy bgn_dpby \ua^hjh\e_gb_ E_q_gb_ kbfilhfZlbq_kdh_

Ij_ju\Zgb_ [_j_f_gghklb g_ lj_[m_lky <hafh`gZ \ZdpbgZpby `b\hc \Zdpbghc m

ijb\bluo ihy\eyxlky Zglbl_eZ d \bjmkm >ebl_evghklv ihke_^mxs_c aZsblu hl bgnbpbjh\Zgby g_ mklZgh\e_gZ Ohly jbkd ^ey ieh^Z y\ey_lky ebrv l_hj_lbq_kdbf bffmgbaZpby `b\hc \Zdpbghc ijb [_j_f_gghklb g_ j_dhf_g^m_lky

VI. BgnexwgpZ ]jbii

<ha[m^bl_ev hlghkblky d fbdkh\bjmkZf Ih Zglb]_gghfm khklZ\m jZaebqZxl ljb lbiZ \bjmkZ Lbi : y\ey_lky ijbqbghc [hevrbgkl\Z wib^_fbc b gZb[he__ ly`_euo kemqZ_\ aZ[he_\Zgby Lbi < j_`_ y\ey_lky ijbqbghc wib^_fbc b oZjZdl_j_g fy]dbfb nhjfZfb l_q_gby aZ[he_\Zgby Lbi K gZb[he__ j_^dh \klj_qZxsbcky \ha[m^bl_ev aZ[he_\Zgby

QZklhlZ b ly`_klv aZ[he_\Zgby k\yaZgu k baf_g_gb_f \ Zglb]_gghc kljmdlmj_ \bjmkZ AgZqbl_evgu_ baf_g_gby ijhbkoh^ysb_ k bgl_j\Zehf \ e_l ijb\h^yl d ly`_ehfm l_q_gbx bgn_dpbb _`_]h^gu_ g_agZqbl_evgu_ baf_g_gby \ Zglb]_gghc kljmdlmj_ \bjmkZ lZdbo ihke_^kl\bc g_ bf_xl Bgdm[Zpbhgguc i_jbh^ ijh^he`Z_lky

^gy Debgbq_kdb_ ijhy\e_gby gZqbgZykv \g_aZigh ijh^he`Zxlky hdheh ^g_c >bZ]gha ih^l\_j`^Z_lky \u^_e_gb_f \bjmkZ ba kfu\h\ ]ehldb hkljuc i_jbh^ beb o

10

djZlguf ih^t_fhf lbljZ Zglbl_e \ iZjguo ku\hjhldZo hkljuc i_jbh^ j_dhg\Ze_kp_gpby <hafh`gh ijh\_^_gb_ l_klh\ nbdkZpbb dhfie_f_glZ beb lhjfh`_gby ]_fZ]]exlbgZpbb

GZb[he__ hiZkguf hkeh`g_gb_f m [_j_f_gguo y\ey_lky m]jh`ZxsZy `bagb ig_\fhgby Ih ^Zgguf ihemq_gguf ijb wib^_fbyo b ]] [_j_f_ggu_ khklZ\eyeb gZb[he__ h[rbjgmx ]jmiim kj_^b mf_jrbo hl ]jbiiZ FZl_jbgkdZy kf_jlghklv ijb aZ[he_\Zgbb ]jbiihf \ iZg^_fbx ] khklZ\beZ hdheh Z \ kemqZyo hkeh`g_gguo ig_\fhgb_c ^h < iZg^_fbx ] ^h \k_o kemqZ_\ kf_jlb ijb aZ[he_\Zgbb ]jbiihf ijboh^behkv gZ [_j_f_gguo

<ebygb_ gZ ieh^ g_agZqbl_evgh K\_^_gby h[ mjh^kl\Zo ieh^Z ijhlb\hj_qb\u lZf ]^_ k\yav k mjh^kl\Zfb ieh^Z gZc^_gZ hgb gZb[he__ \_jhylgu ijb aZ[he_\Zgbb \ ljbf_klj_ [_j_f_gghklb %) b gZb[he__ oZjZdl_jgufb y\eyxlky ihjhdb k_j^pZ Gh \ jy^_ bkke_^h\Zgbc k\yav aZ[he_\Zgby ]jbiihf k ZghfZebyfb ieh^Z hljbpZ_lky Lh `_ dZkZ_lky b ^jm]bo hkeh`g_gbc [_j_f_gghklb ;hevrbgkl\h [_j_f_gguo aZ[he_\rbo ]jbiihf bf_xl ghjfZevguc i_jbgZlZevguc bkoh^

E_q_gb_ bgnexwgpu kbfilhfZlbq_kdh_ ijb ijbagZdZo ig_\fhgbb dhlhjZy m [_j_f_gguo l_q_l ly`_e__ g_h[oh^bfZ ]hkiblZebaZpbb b Zglb[bhlbdhl_jZiby Ijbf_g_gb_ ijb [_j_f_gghklb ZfZglZ^bgZ g_ j_dhf_g^m_lky l d m `b\hlguo hlf_q_gh _]h l_jZlh]_ggh_ ^_ckl\b_ <hafh`gZ \ZdpbgZpby ij_iZjZlZfb m[blh]h \bjmkZ dhlhju_ [_ahiZkgu ^ey [_j_f_gguo b h^bgZdh\h wnn_dlb\gu dZd b \g_ [_j_f_gghklb

VII. Wgl_jh\bjmku

Ij_^klZ\e_gu lj_fy ih^]jmiiZfb JGD kh^_j`Zsbo ibdhjgh\bjmkh\

1.Ihebh\bjmku ij_^klZ\e_gu \bjmkhf ihebhfb_eblZ M [_j_f_gguo fh`_l \uau\Zlv Z[hjlu f_jl\hjh`^_gb_ aZ^_j`dm jhklZ ieh^Z m gh\hjh`^_gguo ihebhfb_ebl <bjmk fh`_l i_j_^Z\Zlvky ieh^m q_j_a ieZp_glm gh [_j_f_gguo k debgbq_kdbfb ijhy\e_gbyfb ihebhfb_eblZ jh`^Zxl a^hjh\uo gh\hjh`^_gguo L_jZlh]_ggh]h wnn_dlZ m \bjmkZ ihebhfb_eblZ g_ hlf_q_gh

2.Woh\bjmku gZkqblu\Zxl ijbf_jgh \b^Z fh]ml \uau\Zlv j_kibjZlhjgu_ aZ[he_\Zgby ]Zkljhwgl_jblu dhgtxgdlb\blu f_gbg]blu i_jbdZj^blu Hkeh`g_gbc [_j_f_gghklb Z[hjlh\ ij_`^_\j_f_gguo jh^h\ f_jl\hjh`^_gbc mjh^kl\ g_ hlf_q_gh Fh`_l [ulv ijbqbghc bgn_dpbb m gh\hjh`^_gguo \hafh`gh \jh`^_gghc ebohjZ^dZ kie_ghf_]Zeby E:I kuiv ihghk j\hlZ hlbl ig_\fhgby f_gbg]bl `_elmoZ Ki_pbnbq_kdh]h e_q_gby beb \Zdpbgu g_ kms_kl\m_l

3.<bjmku DhdkZdb ij_^klZ\e_gu ^\mfy ]jmiiZfb : lbiZ b < lbih\ <bjmku ]jmiiu : aZ j_^dbfb bkdexq_gbyfb g_ \uau\Zxl i_jbgZlZevghc aZ[he_\Z_fhklb <bjmku ]jmiiu < fh]ml \uau\Zlv f_gbg]hwgp_nZebl fbhdZj^bl b j_^dh ]_iZlbl ig_\fhgbx ]_fheblbdh mj_fbq_kdbc kbg^jhf <hafh`gu mjh^kl\Z ieh^Z >hdZaZgZ i_j_^ZqZ \bjmkZ ieh^m q_j_a ieZp_glm Jbkd ^ey ieh^Z g_ hij_^_e_g ;hevrbgkl\h kemqZ_\ bgn_dpbb m fZl_jb g_ ^Z_l hkeh`g_gbc [_j_f_gghklb b ijhoh^bl [_a ihke_^kl\bc ^ey ieh^Z

>bZ]gha \hafh`_g ijb baheypbb \bjmkZ ba ]ehldb beb ijyfhc dbrdb ijb j_]bkljZpbb ih^t_fZ lbljZ Zglbl_e \ i_jbh^ \ua^hjh\e_gby l_klZfb lhjfh`_gby ]_fZ]]exlbgZpbb nbdkZpbb dhfiebf_glZ

VIII. <bjmk iZibeehfu q_eh\_dZ.

>GD kh^_j`Zsbc \bjmk gZkqblu\Z_l [he__ lbih\ bf__l agZq_gb_ dZd ijbqbgZ aehdZq_kl\_gguo gh\hh[jZah\Zgbc iheh\h]h ljZdlZ b j_kibjZlhjgh]h iZibeehfZlhaZ GZb[hevr__ agZq_gb_ ^ey aehdZq_kl\_ggh]h jhklZ bf_xl \bjmku

b lbih\