Prevention and therapy of placental insufficiency and gestosis in pregnant women with hypertensive disease
For the purpose of working out optimal schemes of medication for impaired blood flow in the fetoplacental link and fetal blood flow in fetoplacental insufficiency on the background of maternal arterial hypertension the authors conducted a complex dynamic examination of 175 pregnant women with hypertensive disease stages I and IIА (basic group) at terms of 12–41 wks. The control group comprised 60 women with a non-complicated course of pregnancy and favorable outcomes of labor aged from 18 to 35 years and terms of gestation 12–41 wks, who underwent a complex dynamic examination that included echocardiography of a pregnant woman, Doppler studies of blood flow in the umbilical artery and its terminal branches, and also in the aorta and middle cerebral artery of the fetus, its venous ducts, and the vena cava inferior. The use of highly technological methods of examination (echography, dopplerometry, cardiac flow imaging) and modern laboratory tests (detection of levels of growth factors) permits, based on new understanding of the pathogenesis of placental insufficiency and gestosis, to optimize the obstetric tactics in these complications of pregnancy in women with arterial hypertension and to decrease maternal and perinatal morbidity and mortality. Early detection of impairments of fetoplacental blood flow and their early medication contributed to a decrease of the frequency of adverse perinatal outcomes in pregnant women with arterial hypertension. For instance, FGRT was diagnosed at terms 35–38 wks by 6.8 times more rarely, the neonate received 7 and less Apgar scores by 7 times more rarely. The average term of delivery in this group of pregnant women was 38.9 ± 0.6, and the neonate considerably more rarely (no case in this study) required transition to the 2nd stage of the nursing care plan.