medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»medalphabet-299Research ArticleСтатьиАртериальная гипертензия и беременностьHypertension and pregnancyМравянС. Р.MravyanS. R.noemail@neicon.ruГБУЗ МО «Московский областной научно-исследовательский институт акушерства и гинекологии»РоссияMoscow Regional Research Institute for Obstetrics and GynecologyRussian Federation201727072017323Современная гинекология3136Copyright © Мравян С.Р., 20172017Мравян С.Р.Mravyan S.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/299

В статье освещены современные взгляды на прогноз артериальной гипертензии (АГ) у беременных. Особое внимание уделено патогенезу преэклампсии (ПЭ), являющейся мультисистемным синдром и развивающейся после 20-й недели гестации. Критерии преэклампсии остаются неуточненными и различаются в рекомендациях ряда обществ акушеров и гинекологов. В статье отмечены современные лабораторные критерии преэклампсии - маркеры ангиогенеза (плацентарный фактор роста и fms-подобная тирозинкиназа-1). Определение их является высокочувствительным и специфичным показателем прогноза этого грозного осложнения. С тяжестью ПЭ у беременных также коррелирует увеличение содержания гомоцистеина в плазме крови. Суточное мониторирование артериального давления (СМАД) является объективным методом диагностики АГ у беременных, позволяющим дифференцировать АГ «белого халата» от других форм заболевания. Важными критериями преэклампсии могут быть показатели СМАД: гипербарический индекс, пульсовое давление, циркадная вариация артериального давления, ночное повышение АД, а также бра-дидиастолический тип кривой. Абсолютно безопасным препаратом для лечения АГ у беременных является допегит, однако эффективность его крайне невелика, в том числе при использовании в высоких дозировках. Хорошим антигипертензивным эффектом обладают антагонисты кальция и ß-адреноблокаторы, причем положительное действие последних часто превышает возможные побочные действия. Автором подчеркивается необходимость проведения дополнительных исследований по этой проблеме

The article describes modern views on the prognosis of arterial hypertension (AH) in pregnant women. Special attention is paid to the pathogenesis of preeclampsia (PE), which is a multisystem syndrome developing after 20 weeks of gestation. Criteria of pre-eclampsia remain unspecified and vary the recommendations of a number of societies of obstetricians and gynecologists. The article stresses modern laboratory criteria of preeclampsia markers of angiogenic (placental growth factor and fms-like tyrosine kinase-1). The definition is highly sensitive and specific indicator of prognosis of this serious complication. The content of homocysteine in plasma is correlated with the severity of PE. 24-hour ambulatory blood pressure measurement (ABPM) is an objective method of diagnosis of hypertension in pregnancy, allowing to differentiate white coat' hypertension from other forms of the disease. Important criteria of preeclampsia may be the ABPM parameters: hyperbaric index, pulse pressure, circadian variation of blood pressure, sleep hypertension, as well as bradi-diastolic curve type. Completely safe drug for the treatment of hypertension in pregnant women is dopegit, however, the effectiveness is very small, in particular when used in high dosages. Good antihypertensive effect have calcium antagonists and ß-blockers, and positive action of the latter often exceeds the possible side effects. The author emphasizes the need for additional research of this problem.

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The authors declare that there are no conflicts of interest present.