DOI: 10.18413/2658-6533-2023-9-1-0-8

The state of microcirculation in pregnant women with hypertensive disorders in the third trimester of pregnancy

Background: Hypertensive disorders during pregnancy remain the most significant problem of modern obstetrics, taking the main place in the structure of maternal and prenatal mortality and morbidity. The development of hypertensive disorders during gestation is associated with disturbances in the microcirculation system, the state of which is determined by the morphological and functional properties of its components. A comprehensive study of the state of microcirculation in pregnant women with arterial hypertension will expand the understanding of its role in the pathogenesis of hypertensive disorders. The aim of the study: To evaluate the state of the microcirculatory system and its regulation in pregnant women with various genesis hypertensive disorders in the third trimester of pregnancy. Materials and methods: A total of 151 women in the third trimester of pregnancy were examined at Gorodkov Research Institute of Mother and Child, Ivanovo. The study involved 101 patients with hypertensive disorders of various origins, including 21 women with moderate preeclampsia, 24 women with severe preeclampsia, 35 women with chronic hypertension and 21 women with chronic hypertension plus preeclampsia. The control group consisted of 50 women without signs of hypertensive disorders. Clinical and anamnestic characteristics of the study groups are given. We evaluate aggregation activity of erythrocytes. We studied the state of the microcirculation system and its regulation by laser Doppler flowmetry. Results: All types of hypertensive disorders in pregnant women are accompanied by an increase in the aggregation activity of erythrocytes, which is confirmed by an increase in the average aggregate size, aggregation index and a decrease in the percentage of non-aggregated erythrocytes. According to laser Doppler flowmetry, in pregnant women with hypertensive disorders, morphological and functional disorders of microvessels were revealed against the background of inhibition of active and activation of passive mechanisms of microcirculation regulation with a predominance of pathological types of microcirculation. Conclusion: Microcirculation disorders in pregnant women with hypertensive disorders are diverse and are associated with rheological changes in the blood and pathology of microvessels.

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