ACADEMIC AND RESEARCH PEER-REVIEWED MEDICAL JOURNALISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Specifics of Pregnancy in Patients with Hypertensive Disorders

DOI:10.31550/1727-2378-2019-166-11-14-21
For citation: Muminova K.T., Khodzhaeva Z.S., Shmakov R.G. Specifics of Pregnancy in Patients with Hypertensive Disorders. Doctor.Ru. 2019; 11(166): 14–21. DOI: 10.31550/1727-2378-2019-166-11-14-21
1 October 12:03

Study Objective: comparative analysis of pregnancy progress and outcome in patients with various hypertensive disorders.
Study Design: open prospective study.
Materials and Methods: the study included 165 pregnant women (mean age: 31.72 ± 3.47 years), divided into 6 groups: Sub-group IА — patients with early moderate preeclampsia (PE); sub-group IВ — patients with early severe PE; sub-group IIА — patients with late moderate PE; sub-group IIВ — patients with late severe PE; group III — patients with gestational arterial hypertension (GAH); group IV — patients with chronic arterial hypertension (CAH); group V — CAH-associated PE, group VI (controls) — uncomplicated pregnancy. The women underwent clinical, laboratory and instrumental examination.
Study Results: patients with early severe PE were statistically significantly older than patients with late moderate PE and controls. Body mass index of women with CAH, GAH and CAH-associated PE was higher than that in controls. Differences in family and obstetric history of pregnant women with various hypertensive disorders, which are an unfavourable background affecting the course of pregnancy, were identified.
The manifestation of PE symptoms and complications in trimester II was statistically higher in patients with early severe PE. Foetal growth retardation syndrome (FGRS) was diagnosed only in case of severe PE and CAH-associated PE (15%), HELLP syndrome was recoded in patients with severe PE.
Children with FGRS were more frequently born in the sub-group of early severe PE (ESPE); the rate of complications in early neonatal period in the groups of early PE and CAH-associated PE is quite high. Early neonatal death was recorded in ESPE and CAH-associated PE groups.
Conclusion: when assessing clinical and history risk factors, while focusing on previous PE, it is advisable to take a group of women for thorough monitoring from the very early stage of pregnancy, in order to prevent failures (miscarriage, hypertensive complications, foetal growth retardation syndrome). Taking into account that early and late severe PE as well as CAH-associated PE are the most severe hypertensive disorders in pregnant women, it is recommended to refer such pregnant women to group 3 treatment and prevention institutions.

K.T. Muminova — V.I. Kulakov National Medical Scientific Centre of Obstetrics, Gynaecology and Perinatal Medicine of the Ministry of Health of Russia; 4 Academician Oparin St., Moscow, Russian Federation 117997. eLIBRARY.RU SPIN: 2893-9966. ORCID: http:// orcid.org/0000-0003-2708-4366. E-mail: kamika91@mail.ru

Z.S. Khodzhaeva — V.I. Kulakov National Medical Scientific Centre of Obstetrics, Gynaecology and Perinatal Medicine of the Ministry of Health of Russia; 4 Academician Oparin St., Moscow, Russian Federation 117997. eLIBRARY.RU SPIN: 9714-5970. ORCID: http:// orcid.org/0000-0001-8159-3714. E-mail: zkhodjaeva@mail.ru

R.G. Shmakov — V.I. Kulakov National Medical Scientific Centre of Obstetrics, Gynaecology and Perinatal Medicine of the Ministry of Health of Russia; 4 Academician Oparin St., Moscow, Russian Federation 117997. eLIBRARY.RU SPIN: 3804-3269. ORCID: http:// orcid.org/0000-0002-2206-1002. E-mail: r_shmakov@oparina4.ru

Contribution: Muminova K.T. — patient selection and examination, article preparation, thematic publications reviewing; Khodzhaeva Z.S. — patient selection and examination, data processing analysis and interpretation, article preparation; Shmakov R.G. — review of critically important material, approval of the manuscript for publication.

The authors declare that they do not have any conflict of interests.

Доктор.ру
1 October 12:03
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