Comparison of the course and outcomes of pregnancies complicated by hypertensive disorders
- Authors: Shelekhin A.P.1, Baev O.R.2,1, Krasnyi A.M.2
-
Affiliations:
- I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
- Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
- Issue: No 1 (2023)
- Pages: 41-47
- Section: Articles
- URL: https://ogarev-online.ru/0300-9092/article/view/273971
- DOI: https://doi.org/10.18565/aig.2022.248
- ID: 273971
Cite item
Open Access
Access granted
Subscription Access
Abstract
Objective: To compare the course of pregnancy, childbirth, and pregnancy outcomes in patients with hypertensive disorders. Materials and methods: A retrospective study enrolled 335 pregnant women, who were divided into 6 groups. Group 1 included uncomplicated pregnancies (control group, n=60), Group 2 included patients with gestational arterial hypertension (GAH, n=55), Group 3 included patients with chronic arterial hypertension (CAH, n=60), Group 4 included patients with moderate preeclampsia (MPE, n=60), Group 5 included patients with severe preeclampsia (SPE, n=50), Group 6 included patients with preeclampsia superimposed on chronic arterial hypertension (PE/CAH, n=50). Results: Pregnant women with hypertensive disorders were older and had a higher body weight than women in the control group. Women with SPE and PE/CAH were more likely to have a history of PE. The highest rate of edema was observed in the MPE group. Compared to the GAH and CAH groups, uterine-placental and fetal-placental blood flow disorders were significantly more often diagnosed in patients with PE. Pregnancies with SPE were more often complicated by fetal growth restriction and HELLP syndrome. The highest preterm birth was observed in the SPE (52%) and PE/CAH (44%) groups. Most low-birthweight deliveries and neonatal complications occurred in the SPE and PE/CAH groups. Conclusion: The most adverse maternal and perinatal outcomes were observed in the early-onset hypertensive disorders, especially in patients with SPE and PE/CAH. Particular attention should be paid to women with CAH, who constitute the basis of the PE/CAH group and have a high rate of operative delivery.
Full Text
##article.viewOnOriginalSite##About the authors
Artemiy P. Shelekhin
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Email: dr.shelekhin@gmail.com
Postgraduate Student
Oleg R. Baev
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Email: o_baev@oparina4.ru
Dr. Med. Sci., Professor, Head of the 1st Maternity Department; Professor at the Department of Obstetrics, Gynecology, Perinatology and Reproductology
Alexey M. Krasnyi
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
Email: a_krasnyi@oparina4.ru
PhD, Head of the Cytology Laboratory
References
- Sutton A.L.M., Harper L.M., Tita A.T.N. Hypertensive disorders in pregnancy. Obstet. Gynecol. Clin. North Am. 2018; 45(2): 333-47. https://dx.doi.Org/10.1016/j.ogc.2018.01.012.
- Chahine K., Sibai B. Chronic hypertension in pregnancy: new concepts for classification and management. Am. J. Perinatol. 2019; 36(2): 161-8. https://dx.doi.org/10.1055/s-0038-1666976.
- Hauspurg A., Countouris M.E., Catov J.M. Hypertensive disorders of pregnancy and future maternal health: how can the evidence guide postpartum management? Curr. Hypertens. Rep. 2019; 21(12): 96. https://dx.doi.org/10.1007/S11906-019-0999-7.
- Guedes-Martins L. Superimposed preeclampsia. Adv. Exp. Med. Biol. 2017; 956: 409-17. https://dx.doi.org/10.1007/5584_2016_82.
- Buyukeren M., Qelik H.T., Orgul G., Yigit §., Beksag M.S., Yurdakok M. Neonatal outcomes of earlyand late-onset preeclampsia. Turk. J. Pediatr. 2020; 62(5): 812. https://dx.doi.org/10.24953/turkjped.2020.05.013.
- Brown M.A., Magee L.A., Kenny L.C., Karumanchi S.A., McCarthy F.P., Saito S. et al. The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens. 2018; 13: 291-310. https://dx.doi.org/10.1016Zj.preghy.2018.05.004.
- Bokslag A., van Weissenbruch M., Mol B.W., de Groot C.J.M. Preeclampsia: short and long-term consequences for mother and neonate. Early Hum. Dev. 2016; 102: 47-50. https://dx.doi.org/10.1016AEARLHUMDEV.2016.09.007.
- Shen M., Smith G.N., Rodger M., White R.R., Walker M.C., Wen S.W. Comparison of risk factors and outcomes of gestational hypertension and pre-eclampsia. PloS One. 2017; 12(4): e0175914. https://dx.doi.org/10.1371/JOURNAL.PONE.0175914.
- Agrawal A., Wenger N.K. Hypertension during pregnancy. Curr. Hypertens. Rep. 2020; 22(9): 64. https://dx.doi.org/10.1007/S11906-020-01070-0.
- Министерство здравоохранения Российской Федерации. Преэклампсия. Эклампсия. Отеки, протеинурия и гипертензивные расстройства во время беременности, в родах и послеродовом периоде. Клинические рекомендации. 2021.
- Хлестова Г.В., Карапетян А.О., Шакая М.Н., Романов А.Ю., Баев О.Р. Материнские и перинатальные исходы при ранней и поздней преэклампсии. Акушерство и гинекология. 2017; 6: 41-7. https://dx.doi.org/10.18565/aig.2017.6.41-7.
- Hagans M.J., Stanhope K.K., Boulet S.L., Jamieson D.J., Platner M.H. Delivery outcomes after induction of labor among women with hypertensive disorders of pregnancy. J. Matern. Fetal Neonatal Med. 2022; 35(25): 9215-21. https://dx.doi.org/10.1080/14767058.2021.2022645.
- Муминова К.Т., Ходжаева З.С., Шмаков Р.Г. Особенности течения беременности у пациенток с гипертензивными расстройствами. ДокторРу. 2019; 166(11): 14-21. https://dx.doi.org/10.31550/1727-2378-2019-166-11-14-21.
Supplementary files
