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8. O'Mahony D, O'Sullivan D, Byrne S. et al. STOPP / START Criteria for Potentially Inappropriate Prescribing of Medicines to the Elderly: Version 2. Age Aging., 2015. Mar. 44 (2): 213-8. doi: 10.1093 / aging / afu145. Epub 2014. Oct 16.
9. Violan C., Foguet-Boreu Q., Flores-Mateo G. et al. Prevalence, determinants and patterns of multimorbidity in primary care: a systematic review of observational studies. APPROVES, 2014 Jul 219 (7): e102149. doi: 10.1371 / journal.pone.0102149. eCollection 2014.
HYPERTENSIVE AND VEGETATIVE CRISES DURING PREGNANCY: EPIDEMIOLOGY, RISK FACTORS AND STRATEGIC DIRECTIONS FOR PREVENTION IN THE CONDITIONS OF THE FERGANA VALLEY Kuziyeva G.A.1, Asrankulova D.B.2 Em ail: Kuziyeva17161 @scientifictext.ru
'Kuziyeva Gulruh Alijonovna - Assistant; 2Asrankulova Diloram Bahtiyarovna - Doctor of Medical Sciences, Professor, DEPARTMENT OF OBSTETRICS AND GYNECOLOGY № ', AND1.JAN STATE MEDICAL INSTITUTE, ANDIJAN, REPUBLIC OF UZBEKISTAN
Abstract: arterial hypertension (AH) in pregnant women occupies a special place among the pressing issues of modern medicine. It is an integral part of at least two extremely acute medical and social problems today: hypertension in general and the reproductive health of the nation. The main problem of hypertension in pregnant women: the lack of a unified terminology, the use of different classification and criteria for hypertension, tactics of patient management. We tried, on the basis of evidence-based medicine, to present the classification of hypertension in pregnant women and the principles of drug therapy, including emergency care in hypertensive crisis. Keywords: pregnancy, arterial hypertension, pharmacotherapy.
ГИПЕРТЕНЗИВНЫЕ И ВЕГЕТАТИВНЫЕ КРИЗЫ ПРИ БЕРЕМЕННОСТИ: ЭПИДЕМИОЛОГИЯ, ФАКТОРЫ РИСКА И СТРАТЕГИЧЕСКИЕ НАПРАВЛЕНИЯ ПРОФИЛАКТИКИ В УСЛОВИЯХ ФЕРГАНСКОЙ ДОЛИНЫ Кузиева Г.А.1, Асранкулова Д.Б.2
'Кузиева Гулрух Алижоновна - ассистент; 2Асранкулова Дилорам Бактияровна - доктор медицинских наук, профессор, кафедра акушерства и гинекологии № ', Андижанский государственный медицинский институт, г. Андижан, Республика Узбекистан
Аннотация: артериальная гипертония (АГ) беременных занимает особое место среди актуальных вопросов современной медицины. Она является составной частью как минимум двух чрезвычайно остро стоящих сегодня медико-социальных проблем: АГ в целом и репродуктивного здоровья нации. Основная проблема АГ у беременных: отсутствие единой терминологии, использования различных классификаций и критериев АГ, тактики ведения пациенток. Мы попытались на основе доказательной медицины представить классификацию АГ у беременных и принципы лекарственной терапии, включая неотложную помощь при гипертоническом кризе.
Ключевые слова: беременность, артериальная гипертензия, фармако-терапия.
UDC 6'6 - 009. '2 - 055. 26: 616.839
Relevance. Hypertensive disorders in pregnant women are the main among the most common and most important diseases and syndromes of the cardiovascular system. The significance of this problem
is determined by the fact that pregnancy in women with hypertensive conditions is often accompanied by severe health problems and even the death of the mother (in some countries up to 40%), a high level of child and perinatal morbidity and mortality, as well as a number of obstetric complications [2].
Hypertensive conditions in pregnant women are a concept that combines various clinical and pathogenetic types of hypertensive disorders [5]. In some cases, women before pregnancy have a history of chronic kidney disease, which is an etiological factor in increased blood pressure; in others, essential hypertension; thirdly, in normotensive women before pregnancy, an increase in blood pressure is induced by the pregnancy itself, the so-called gestational forms - gestational hypertension and preeclampsia [1].Moreover, in the structure of the causes of arterial hypertension during pregnancy, the greatest role is played by the latter, which, according to MABrown and MLBuddle [4], account for the prevailing part of all hypertensive disorders in pregnant women: gestational hypertension - 43%, preeclampsia - 27%, essential hypertension - 19%, preeclampsia superimposed on previous hypertension - 7%, secondary (symptomatic) hypertension - 4% [6].
Purpose of the study. To determine the prevalence of the main risk factors for complications of hypertensive and vegetative crises in pregnant women in the Fergana Valley.
Materials and research methods. The analysis of the primary medical documentation of pregnant women has been carried out. The preliminary sample included 86 women who were divided into 3 groups: the control group consisted of 20 women with physiological pregnancy, the 1st main group -30 pregnant women with ADVS, the 2nd main group - 36 pregnant women with arterial hypertension.
Research results. Numerous studies have shown that the risk of pregnancy complications, one of which is preeclampsia, increases in women who have already had preeclampsia in a previous pregnancy; in the presence of antiphospholipid syndrome; diabetes mellitus; multiple pregnancy; first pregnancy; a history of increased blood pressure; an increase in body mass index at the beginning of pregnancy or in history; when the mother is over 40 years old; preeclampsia in relatives (mother, sisters).
Epidemiological studies have shown that preeclampsia is mainly a disease of the first pregnancy. The risk of preeclampsia is usually lower in the second pregnancy than in the first pregnancy if the woman has a new partner for the second pregnancy. One explanation is that the risk is reduced by repeated exposure to specific antigens from the same partner. However, the difference in risk could instead be explained by the interval between births.
Research by Bassoetal. show that it is necessary to take into account the interval between births, because preeclampsia is mainly a disease of the first pregnancy and a factor in partner change. Preeclampsia developed in 3.9% of women during the first pregnancy, in 1.7% during the second pregnancy, and in 1.8% of women during the third pregnancy when the woman was with the same partner. The risks of a second or third pregnancy are directly related to the time that has passed since the previous pregnancy, and when the interval is 10 years or more, the risk approaches that of nulliparous women. The protective effect of a previous pregnancy against preeclampsia is temporary.
Obesity is a serious problem for women during pregnancy and childbirth. About 34% of pregnant women have a BMI (kg / m2) over 25, although recent data indicate that the number of overweight women is approaching 50%. There are well-known risks associated with obesity during pregnancy. Maternal complications include an increased risk of developing hypertension, preeclampsia, gestational diabetes, and infectious complications. Even moderately overweight is a risk factor for gestational diabetes and hypertensive disorders during pregnancy.Women who are overweight or obese are more likely to require induction of labor and have a high percentage of surgical delivery. Low Apgar scores, macrosomia, neural tube defects are more common in children whose mothers are obese than in children whose mothers have a normal body mass index. Maternal obesity increases perinatal mortality.
On average, the cost of prenatal and postnatal care is higher for overweight mothers than for mothers with a normal BMI. Children of overweight mothers need to be admitted to the intensive care unit more often than children of normal weight mothers.
Conclusion: The presented materials on the management of pregnant women with various hypertensive conditions are based on the recommendations of leading foreign societies for the study of hypertension in pregnant women. Arterial hypertension is undoubtedly an urgent problem in pregnant women, requiring early diagnosis and timely treatment, as well as subsequent careful monitoring. Timely initiation of adequate therapy, which is inherently prophylactic, can significantly improve the prognosis of the pregnancy outcome for the mother and for the fetus. Drug treatment should be carried out with caution because of the possible slowing effect of some drugs on the growth and development of the fetus. However, the risk of teratogenic and embryotoxic effects of drugs should not be exaggerated, since refusal to use them justified can harm the health of not only the mother, but also her unborn child.
References / Список литературы
1. Vertkin A.L., Tkacheva O.N., Murashko L.E. and other. Arterial hypertension in pregnant women: diagnosis, management tactics and approaches to treatment // Attending physician, 2006. № 3. S. 25-8.
2. Manukhin I.B., Markova E.V., Markova L.I., Stryuk R.I. Combined low-dose antihypertensive therapy in pregnant women with arterial hypertension and preeclampsia // Cardiology, 2012. № 1. P. 32-38.
3. Svishchenko E.P., Bezrodnaya L.V. Essential arterial hypertension // Guide to cardiology / Ed. V.N. Kovalenko. K.: Morion, 2008. S. 444-480.
4. ClivazMariotti L., Saudan P., Landau Cahana R., Pechere-Bertschi A. Hypertension in pregnancy // Rev. Med. Suisse, 2007. Vol. 3 (124). P. 2015-2016.
5. Mustafa R., Ahmed S., Gupta A., Venuto R.C. A comprehensive review of hypertension in pregnancy // J. Pregnancy, 2012. Vol. 5 (3). P. 534-538.
6. Barry C., Fielding R., Green P. et al. Hypertension in pregnancy: the management of hypertensive disorders during pregnancy / National Collaborating Center for Women's and Children Health // London: Royal of College Obstetrics and Gynecologists, 2010.
IMPORTANCE OF IMMUNOLOGICAL CHARACTERISTICS OF SYMPTOMS OF NOSE INFLAMMATION AND COMPOSITION CLEARANCE IN ALLERGIC RHINITIS Ulmasov A.O.1, Madaminova N.E.2, Kosimov K.K.3 Email: Ulmasov17161@scientifictext.ru
'Ulmasov Alijon Obidovich — Assistant; 2Madaminova Nigora Ergashevna — Assistant; 3Kosimov Kobil Kosimovich - Doctor of Medical Sciences, Professor, DEPARTMENT OF OTORHINOLARYNGOLOGY, ANDIJAN STATE MEDICAL INSTITUTE, ANDIJAN, REPUBLIC OF UZBEKISTAN
Abstract: allergic diseases of the nasal cavity, one of which is allergic rhinitis, significantly reduce the quality of life of patients and are a factor predisposing to the development of bronchial asthma. Currently, many patients with this disease suffer. Patients prone to bronchial asthma struggle with the disease throughout their lives.
The article presents data on the importance of inhalation allergens in the development of allergic rhinitis and describes modern approaches to the diagnosis, treatment and prevention of this disease. In addition, the course in several patients has been described and compared separately. Keywords: allergic rhinitis, allergens, immunological assessment.
ВАЖНОСТЬ ИММУНОЛОГИЧЕСКИХ ХАРАКТЕРИСТИК СИМПТОМОВ ВОСПАЛЕНИЯ НОСА И ОЧИСТКА СОСТАВА ПРИ АЛЛЕРГИЧЕСКОМ РИНИТЕ Улмасов А.О.1, Мадаминова Н.Э.2, Косимов К.К.3
'Улмасов Алижон Обидович — ассистент; 2Мадаминова Нигора Эргашевна — ассистент; 3Косимов Кобил Косимович — доктор медицинских наук, профессор, кафедра оториноларингологии, Андижанский государственный медицинский институт, г. Андижан, Республика Узбекистан
Аннотация: аллергические заболевания полости носа, одним из которых является аллергический ринит, значительно снижают качество жизни пациентов и являются фактором, предрасполагающим к развитию бронхиальной астмы. В настоящее время страдают многие пациенты с этим заболеванием. Пациенты, склонные к бронхиальной астме, борются с заболеванием на протяжении всей жизни.
