Microcirculation disorders in hypertensive disorders in pregnant women

Arterial hypertension poses a threat to both the pregnant woman and the health of the newborn. Vascular disorders play an important role in the pathogenesis of hypertension. A study of microcirculation in arterial hypertension was conducted with the inclusion of 42 women with newly diagnosed or untreated arterial hypertension of grade 1–2 and a control group. Microcirculation was studied by capillaroscopy of the nail bed. The revealed changes in the microcirculatory system in women with arterial hypertension compared with patients without arterial hypertension included changes in the density of the capillary network in the form of rarefaction, degree of tortuosity, enlargement of the perivascular zone, arterial capillaries, venous capillaries, diameter of the transitional capillaries. The study of the prevalence of complications of pregnancy and childbirth in arterial hypertension of pregnant women, as well as its effect on the condition of the newborn. The analysis of 150 SMADS of pregnant women and information from EMIAS was carried out. The prevalence of hypertensive disorders among pregnant women was 19.3%. 69% of pregnant women with hypertension had this disease before pregnancy. An analysis of the complications of current pregnancy in hypertensive disorders showed a high percentage of the incidence of preeclampsia or a high risk of its development (41.38%). The incidence of preeclampsia and a high risk of its development in women without hypertension was 5.3%. Among the complications of pregnancy with hypertension, the following were identified: gestational diabetes mellitus – 31%, anemia of varying severity – 17.2%, gestational hypertension – 10.3%, toxicosis – 6.9%, threat of premature birth – 3.5%, gestational pyelonephritis – 3.5%. When assessing the relationship between hypertension and complications in childbirth, the following data were obtained: preterm birth – 16.7%, cesarean delivery – 47.4%, premature discharge of amniotic fluid/membranes – 21.1%, ruptures of the cervix/perineum – 21.1%, vacuum extraction of the fetus – 5.2%, fetal distress – 10.5%. the birth of children with a height of less than 45 cm and weighing less than 2500 g – 10.5%. The data we obtained coincided with the results of most studies that revealed a high risk of pregnancy and childbirth complications in pregnant women with hypertension. Prediction of arterial hypertension during pregnancy. it is an urgent task. Methods for studying microcirculation are available and can be used for screening surveillance to identify women at risk of hypertensive pregnancy complications at the planning stage.

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