THE ROLE OF HEMODYNAMIC PROCESSES IN CHANGES OF THE UTERUS OF PREGNANT WOMEN WITH PRIMARY ARTERIAL HYPOTENSION
DOI:
https://doi.org/10.11603/24116-4944.2018.2.8735Keywords:
pregnancy, primary arterial hypotension, external tocography, utero-placental hemodynamicsAbstract
The aim of the study – to learn the influence of intrauterine hemodynamic processes on the deliveries of women with primary arterial hypotension.
Materials and Methods. Contractility of the uterus using the method of external tocography in 50 pregnant women during their deliveries and 25 women with uncomplicated course of urgent deliveries was studied. We determined the contractility of the uterus during first period of the delivery – in latent phase-opening of the cervix under 4 cm, 5–6 cm and 7–10 cm. We made dynamic ultrasound examination: transverse size of the regional sinus of placenta (mm). Doplerometric study of utero-placental hemodynamics was made including blood flow in uterinе arterias.
Results and Discussion. In pregnant women with primary arterial hypotension we revealed increase of the latent phase, second period of delivery, so, general duration of the deliveries (p<0.05). When we made comparison of basal intauterinal tonus in women of our control group and the observation group, we revealed decrease in 1.5 times of the basal intrauterine tonus. During the delivery intensity and quantity of the contractions was weaker in 1.5 times in women with primary arterial hypotension and time interval was longer in 1.5–2 times. Uterine activity in latent phase of the delivery was weaker in 3 times, and in active phase – in 1.5 times in comparison with control group. Study of the influence of hemodynamic dysfunction of uterus in women with primary arterial hypotension revealed increase of vasal resistance in right and left uterine arterias, more in right one, which is dominant in the uterine hemodynamics. That provoked increase of the preplacental resistance of blood flow, limitation of blood volume in intervillous space, regional sinus and vasals of the miometry. In pregnant women with primary arterial hypotension: transverse size of regional sinus of placenta was smaller than in control group.
Conclusion. The activation of vasodilation in pregnant women with primary arterial hypotension provokes decrease of systolic and diastolic speed of blood flow in uterine arterias, that causes utero-placental hypoperfusion and slowdown of delivery.
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