Юлия Волкова » Публикация

Аннотация The objective. o study the changes and stages of cardiac, cerebral and renal hemodynamic in the postpartum after normal labor, preeclampsia and eclampsia for assessment of severity hypertensive pregnancy complications and antihypertensive therapy selection. Patients and methods. We performed a prospective longitudinal cohort trial of 90 postpartum women after moderate and severe preeclampsia and eclampsia (main group) and 55 patients after an uncomplicated pregnancy (control group). The parameters of maternal hemodynamics were recorded on 1, 3, 5, 9, 14 day postpartum period, as well as after 2 and 6 months after delivery. It was produced by a complex dynamic Doppler study of blood flow in the carotid arteries (common, external, internal and ophthalmic), renal arteries and their intraorganic branches and echocardiography. Indicators of the control group compared with the hemodynamic parameters nonpregnant patients of reproductive age without somatic diseases (30 cases). Results. After uncomplicated vaginal deliveries on the third day we observed increase of the cardiac parameters (SV, CO, SI, CI) and the simultaneous decreasing SVR, and a reduction vascular resistance in brain and renal arteries as compared to non-pregnant patients (P < 0.05). The indicators back to normal by the end of the postpartum period. After PE and eclampsia on 1-3 days after labor indicators of cardiac hemodynamics were significantly lower, SVR and the cerebral and renal vessels resistance was significantly higher (p < 0.05) than after uncomplicated delivery. Recovery rates depend on the severity of hypertensive disorders. The most long-term increasing of the vascular resistance were in the ophthalmic artery and arteries of the renal parenchyma. After eclampsia PI, IR in these vessels do not reach to the standard values even after 6 weeks (p < 0.05). Conclusion. The study of maternal hemodynamics is very important for an objective assessment of the severity of hypertensive complications as during pregnancy, as well as in the postpartum period. Long-term increasing in vascular resistance after undergoing pre-eclampsia and eclampsia especially leads to high risk of cardiovascular diseases. The choice of drugs for antihypertensive therapy is carried out in accordance with the indicators of cardiac hemodynamics.