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Рецепт. 2019; : 81-89

Лечебно-диагностические принципы ведения беременных с артериальной гипертензией

Бельская Е. С., Сиденко В. М., Чиж К. А.

Аннотация

Самым частым заболеванием сердечно-сосудистой системы во время беременности является артериальная гипертензия. В клинической практике с этим заболеванием сталкиваются терапевты, кардиологи, акушеры-гинекологи, педиатры и врачи других специальностей. Актуальность проблемы заключается в том, что гипертензивные состояния являются основной причиной осложнений у беременных женщин во время гестации, а также повышают риск возникновения неврологических и сердечно-сосудистых заболеваний у детей. Кроме того, артериальная гипертензия у беременных относится к факторам риска развития заболевания почек, ишемической болезни сердца и прогрессирования гипертензии после родов. В статье рассмотрены вопросы диагностики, классификации и дифференцированного подхода к выбору антигипертензивной терапии во время беременности.

Список литературы

1. Adamyan L.V., Artimuk N.V., Bashmakova N.V. i dr. (2016) Gipertenzivnie rasstroĭstva vo vremya beremennosti, v rodah i v poslerodovom periode. Klinicheskie rekomendatsii (protokoli lecheniya) [Hypertensive disorders during pregnancy, delivery and in the postpartum period. Clinical recommendations (treatment protocols)]. M.: 72 p. (in Russian)

2. (2018) Diagnostika i lechenie serdeno-sosudistih zabolevanii pri beremennosti. Natsional’nie rekomendatsii [Diagnosis and treatment of cardiovascular diseases during pregnancy. National recommendations]. Rossiiskii kardiologicheskii zhurnal [Russian cardiological journal], vol. 3 (155), pp. 91-134.

3. IonovM.V.,ZvartauN.E.,KonradiA.O.Sovmestnieklinicheskierekomendatsii[Mutualсlinicalrecommendations].

4. (2018) ESH/ESC 2018 po diagnostike i vedeniyu patsientov s arterial’noi gipertenziei: pervii vzglyad [ESH/ ESC 2018 on diagnosis and management of patients with arterial hypertension: the first view]. Arterial’naya gipertenziya [Arterial hypertension], vol. 24(3), pp. 351-358.

5. (2017) Klinicheskii protokol diagnostiki i lecheniya zabolevanii, harakterizuyuschihsya povishennim krovyanim davleniem. Prilozhenie 1 k postanovleniyu Ministerstva zdravoohraneniya Respubliki Belarus’ [Clinical protocol on diagnosis and treatment of diseases which are characterized by elevated blood pressure], razdel 4, pp. 24-42.

6. (2007) Lechebno-diagnosticheskaya taktika vedeniya beremennih s arterial’noi gipertoniei v Rossii [Therapeutic and diagnostic management of pregnant women with arterial hypertension in Russia]. M.: izdatel’stvo Rashin Prodakshn, 136 p. (in Russian)

7. Stryuk R.I., Berns S.A., Filippova M.P. i dr. (2018) Serdechno-sosudistie zabolevaniya i assotsiirovannie s nimi komorbidnie sostoyaniya kak faktori, opredelyayuschie neblagopriyatnie perinatal’nie ishodi pri beremennosti - analiz dannih registra beremennih “BEREG”. Ter. Arhiv. [Cardiovascular diseases and associated with them comorbid conditions as the factors determining adverse perinatal outcomes in pregnancy - data analysis of pregnant women register “BEREG”. Ter. Archive], vol. 1 (90): pp. 9-16.

8. (2013) American College of Obstetricians and Gynecologists, Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstetrics and Gynecology, vol. 122 (5), pp. 1122-31.

9. Hofmeyr G.J., Lawrie T.A., Atallah A.N. et al. (2014) Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev., vol. 6: CD001059.

10. Magee L.A., Pels A., Helewa M. et al. (2014) Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Pregn. Hypertens, vol. 4, pp. 105-45.

11. Rolnik D.L., Wright D., Poon L.C. et al. (2017) Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia. N Engl J Med, vol. 377 (7), pp. 613-22.

12. (2018) The Task Force for the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC) European Heart Journal, 00, pp. 1-83.

13. Tranquilli A.L., Dekker G., Magee L. et al. (2014) The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP. Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health.; vol. 4, pp. 97-104.

Recipe. 2019; : 81-89

Therapeutic and Diagnostic Principles of Management of Hypertension in Pregnancy

Belskaja E. ., Sidzenka V. ., Chizh K. .

Abstract

Hypertension is the most common pathology of cardiovascular system in pregnant women. The latter is often case in practice of internists, cardiologists, obstetricians, pediatricians, and other medical professionals. The urgency of this issue is determined by induction of the most complications of pregnancy and increasing the risk of neurological and cardiovascular diseases in children. Furthermore, hypertension can raise the likelihood of developing kidney disease and coronary heart disease during pregnancy as well as progression of blood pressure elevation in women after delivery. The article provides information related to diagnosis, classification, and differentiated approach to antihypertensive therapy in pregnancy.
References

1. Adamyan L.V., Artimuk N.V., Bashmakova N.V. i dr. (2016) Gipertenzivnie rasstroĭstva vo vremya beremennosti, v rodah i v poslerodovom periode. Klinicheskie rekomendatsii (protokoli lecheniya) [Hypertensive disorders during pregnancy, delivery and in the postpartum period. Clinical recommendations (treatment protocols)]. M.: 72 p. (in Russian)

2. (2018) Diagnostika i lechenie serdeno-sosudistih zabolevanii pri beremennosti. Natsional’nie rekomendatsii [Diagnosis and treatment of cardiovascular diseases during pregnancy. National recommendations]. Rossiiskii kardiologicheskii zhurnal [Russian cardiological journal], vol. 3 (155), pp. 91-134.

3. IonovM.V.,ZvartauN.E.,KonradiA.O.Sovmestnieklinicheskierekomendatsii[Mutualslinicalrecommendations].

4. (2018) ESH/ESC 2018 po diagnostike i vedeniyu patsientov s arterial’noi gipertenziei: pervii vzglyad [ESH/ ESC 2018 on diagnosis and management of patients with arterial hypertension: the first view]. Arterial’naya gipertenziya [Arterial hypertension], vol. 24(3), pp. 351-358.

5. (2017) Klinicheskii protokol diagnostiki i lecheniya zabolevanii, harakterizuyuschihsya povishennim krovyanim davleniem. Prilozhenie 1 k postanovleniyu Ministerstva zdravoohraneniya Respubliki Belarus’ [Clinical protocol on diagnosis and treatment of diseases which are characterized by elevated blood pressure], razdel 4, pp. 24-42.

6. (2007) Lechebno-diagnosticheskaya taktika vedeniya beremennih s arterial’noi gipertoniei v Rossii [Therapeutic and diagnostic management of pregnant women with arterial hypertension in Russia]. M.: izdatel’stvo Rashin Prodakshn, 136 p. (in Russian)

7. Stryuk R.I., Berns S.A., Filippova M.P. i dr. (2018) Serdechno-sosudistie zabolevaniya i assotsiirovannie s nimi komorbidnie sostoyaniya kak faktori, opredelyayuschie neblagopriyatnie perinatal’nie ishodi pri beremennosti - analiz dannih registra beremennih “BEREG”. Ter. Arhiv. [Cardiovascular diseases and associated with them comorbid conditions as the factors determining adverse perinatal outcomes in pregnancy - data analysis of pregnant women register “BEREG”. Ter. Archive], vol. 1 (90): pp. 9-16.

8. (2013) American College of Obstetricians and Gynecologists, Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstetrics and Gynecology, vol. 122 (5), pp. 1122-31.

9. Hofmeyr G.J., Lawrie T.A., Atallah A.N. et al. (2014) Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev., vol. 6: CD001059.

10. Magee L.A., Pels A., Helewa M. et al. (2014) Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Pregn. Hypertens, vol. 4, pp. 105-45.

11. Rolnik D.L., Wright D., Poon L.C. et al. (2017) Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia. N Engl J Med, vol. 377 (7), pp. 613-22.

12. (2018) The Task Force for the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC) European Heart Journal, 00, pp. 1-83.

13. Tranquilli A.L., Dekker G., Magee L. et al. (2014) The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP. Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health.; vol. 4, pp. 97-104.