FEATURES OF REALIZATION OF "PHENOMENON OF HYPOTENSIVE ACTION OF GESTATION PROCESS" IN PREGNANT WOMEN WITH IDIOPATHIC ARTERIAL HYPOTENSION

Authors

  • L. B. Markin Danylo Halytsky Lviv National Medical University
  • O. I. Popovych Danylo Halytsky Lviv National Medical University
  • A. I. Popovych Danylo Halytsky Lviv National Medical University

DOI:

https://doi.org/10.11603/24116-4944.2021.1.12365

Keywords:

pregnancy, idiopathic hypotension, complications of pregnancy, placental morphology

Abstract

The aim of the study – to identify the leading manifestations of the "phenomenon of hypotensive effect of pregnancy" in women with idiopathic hypotension (IAH).

Materials and Methods. Central hemodynamics were assessed using bioimpedancemetry using the APK-01 circulatory analyzer and Doppler examination of uterine-placental blood flow in the uterine arteries (UA) in 50 pregnant women with IAH and 32 pregnant women with normal blood pressure (BP) at 30–32 gestation. Monitoring of fetal heart rate was performed according to cardiotachogram (CTG). Morphological examination of the placenta of women in labor was performed according to standard methods (tissue staining with hematoxylin-eosin) using a light optical microscope "LOMO" with standard magnifications: × 10 × 20 × 40 × 100.

Results and Discussion. Physiological decrease in blood pressure in 48.0 % of pregnant women with IAH was accompanied by the appearance of signs of "vasovagal fainting". The features of the clinic were formed with the participation of the autonomic nervous system and indicated autonomic imbalance in pregnant women with IAH. The study of central hemodynamic parameters in pregnant women with IAH revealed in 22.0 % of cases a significant decrease in circulatory volume, such as SV and MV of the heart, which was a trigger for reduced perfusion of organs and tissues and, consequently, impaired uteroplacental blood flow. Doppler study of blood flow in UA revealed a moderate increase in pulsation index (PI) in 28.0 % of pregnant women with IAH; indicators of vascular resistance of UA were higher, on average, by 19.0 % than in the control group. Insufficient supply of placental tissue with oxygenated blood led to the development of compensated fetal distress in 18.0 % of pregnant women with IAH. The morphological picture of the placenta confirmed the presence of chronic placental dysfunction in women with IAH in the form of destruction of a significant number of parenchymal elements and rheological disorders in the intervillous space.

Conclusions. Providing assistance to pregnant women with IAH involves taking into account the effect of "phenomenon of hypotensive action of pregnancy", the organization of effective monitoring of the gestational process.

Author Biographies

L. B. Markin, Danylo Halytsky Lviv National Medical University

Doctor of Medical Sciences, Professor, Corresponding Member of the National Academy of Medical Sciences of Ukraine, Head Department of Obstetrics and Gynecology, Danylo Halytsky Lviv National Medical University

O. I. Popovych, Danylo Halytsky Lviv National Medical University

graduate student of the Department of Obstetrics and Gynecology, Danylo Halytsky Lviv National Medical University

A. I. Popovych, Danylo Halytsky Lviv National Medical University

PhD in Medicine, Associate Professor of the Department of Obstetrics and Gynecology, Danylo Halytsky Lviv National Medical University

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Published

2021-09-09

How to Cite

Markin, L. B., Popovych, O. I., & Popovych, A. I. (2021). FEATURES OF REALIZATION OF "PHENOMENON OF HYPOTENSIVE ACTION OF GESTATION PROCESS" IN PREGNANT WOMEN WITH IDIOPATHIC ARTERIAL HYPOTENSION. Actual Problems of Pediatrics, Obstetrics and Gynecology, (1), 110–114. https://doi.org/10.11603/24116-4944.2021.1.12365

Issue

No. 1 (2021)

Section

OBSTETRICS AND GYNECOLOGY

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