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HYPERTENSIVE DISORDERS IN PREGNANT WOMEN: PREVALENCE, RISK FACTORS, PHARMACOEPIDEMIOLOGY AND PERSONALIZED
APPROACH TO PREVENTION Goziyeva Sh.S.1, Asrankulova D.B.2 Email: Goziyeva17161@scientifictext.ru
'Goziyeva Shoista Sultonbekovna—Assistant; 2Asrankulova Diloram Bahtiyarovna - Doctor of Medical Sciences, Professor, DEPARTMENT № 1 OF OBSTETRICS AND GYNECOLOGY, ANDIJAN STATE MEDICAL INSTITUTE, ANDIJAN, REPUBLIC OF UZBEKISTAN
Abstract: the article deals with the classification, diagnosis, clinical course of various types of arterial hypertension during pregnancy. The tactics of management of pregnant women with chronic and gestational arterial hypertension, preeclampsia are described.
Modern approaches to antihypertensive therapy of patients with hypertensive disorders during pregnancy and in the postpartum period are presented. Attention is drawn to the rehabilitation of women with arterial hypertension and the prevention of preeclampsia. Keywords: pharmacoepidemiology, hypertensive disorders, prevention, pregnant woman.
ГИПЕРТЕНЗИВНЫЕ РАССТРОЙСТВА У БЕРЕМЕННЫХ: РАСПРОСТРАНЕННОСТЬ, ФАКТОРЫ РИСКА, ФАРМАКОЭПИДЕМИОЛОГИЯ И ПЕРСОНАЛИЗИРОВАННЫЙ ПОДХОД К ПРОФИЛАКТИКЕ Гозиева Ш.С.1, Асранкулова Д.Б.2
1Гозиева Шоиста Султонбековна — ассистент; 2Асранкулова Дилорам Бахтияровна — доктор медицинских наук, профессор, кафедра № 1 акушерства и гинекологии, Андижанский государственный медицинский институт, г. Андижан, Республика Узбекистан
Аннотация: в статье рассмотрены вопросы классификации, диагностики, клинического течения различных вариантов артериальной гипертензии во время беременности. Изложена тактика ведения беременных с хронической и гестационной артериальной гипертензией, преэклампсией.
Представлены современные подходы к антигипертензивной терапии пациентов с гипертензивными расстройствами во время беременности и в послеродовом периоде. Обращено внимание на реабилитацию женщин с артериальной гипертензией и профилактику преэклампсии.
Ключевые слова: фармакоэпидемиология, гипертензиные расстройства, профилактика, беременная женщина.
UDC 618.3:616-009.12-084-07
Relevance. Hypertensive disorders during pregnancy occur in about 10% of pregnancies; the incidence of preeclampsia is 2-8% [3,7]. Every year more than 50,000 women all over the world die during pregnancy due to complications associated with hypertension [1,6].
In developed countries, in 12-18% they are the second direct cause of ante- and postnatal mortality, affecting perinatal mortality in 20-25% of cases [4,8].
However, with proper interdisciplinary management, most adverse outcomes are preventable. Since the consequences of severe hypertensive disorders reduce the quality of a woman's later life (high incidence of atherosclerosis, diabetes mellitus, cardiovascular diseases), and the incidence of impaired physical, psychosomatic development of prematurely born children is quite high, as well as the risk of developing somatic diseases in the future, then this problem is significant in social and medical terms [2,5].
Purpose of the study. To reveal the influence of modified lifestyle factors contributing to the development of pelvic floor muscle failure (for example, the obturator muscle of the lower third of the vagina).
Materials and methods of research. 104 primiparous women were under observation. The main group consisted of 64 women with the influence of modifiable risk factors. The control group included 40 pregnant women in whom the influence of risk factors was absent.
Results of the study. The study of the contractile ability of the pelvic muscles was carried out according to a technique developed by us using a special device (patent for a useful model No. 78415 RU) and by the method of computer vaginotensometric research (CVTR) (patent for an invention No. 2364336 RU).
The strength of tonic, maximum, volitional contractions and their duration were assessed. The assessment of the degree of insufficiency of the strength of contractions was carried out according to the classification, where the normal strength of tonic contraction was considered more than 15.00 gf, maximum - more than 70.00 gf, volitional - more than 55.00 gf, normal duration - more than 5 s. The strength of tonic contraction from 14.00 to 10.00 gf, maximum - from 69.00 to 50.00 gf, volitional -from 54.00 to 40.00 gf, duration from 4.00 to 2, was qualified as a failure of the first degree. 00 s.The strength of tonic contraction from 9.00 to 6.00 gf, maximum - from 49.00 to 21.00 gf, volitional - from 39.00 to 16.00 gf, duration - from 2.0 to 1 , 0 s. Insufficiency of the third degree was established when the strength of tonic contraction was less than 5.0 gf, maximum - less than 20.00 gf, volitional - less than 15.00 gf, duration - less than 1 s.
The age of women in both groups ranged from 18 to 36 years, averaging 25.6 ± 0.26 years. The main factor affecting the body was chronic intoxication, which was detected in 33 (51.5%) women in the main group and in 5 (12.5%) women in the control group. At CVTR it was found that the minimum strength of tonic contraction was observed in smokers in the main group - 12.34 ± 0.61 gf, and the maximum - in women in the control group with no risk factors - with a duration of more than 6.02 ± 0.3 s.
Normal body weight was observed in 42 (65.6%) women in the main and 32 (80%) control groups. The minimum strength of tonic contraction was observed in women of the main group with a body weight deficit - 13.62 ± 0.68 gf, and the maximum ability to volitional contraction - 60.36 ± 0.60 gf -in women in the control group.
Conclusion: The results of the interim analysis demonstrated the positive effect of HRT with the combined drug Angelique on blood pressure, the degree of visceral obesity, metabolic status and clinical manifestations of climacteric syndrome in women in the early postmenopausal period, risk factors for the development of hypertensive disorders in pregnant women.
In recent years, many studies have shown that the development of arterial hypertension (AH) in pregnant women is due to the influence of risk factors. But to date, there are no convincing data on the prevalence of these factors in the population, and the most significant of them for predicting the development of this complication of pregnancy have not been identified.
References / Список литературы
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2. Volkova E. V., Lysyuk E.Yu., Dzhokhadze L.S. The role of vascular growth factors in the diagnosis of various forms of arterial hypertension in pregnant women // Problems of reproduction, 2012. № 5. S. 102-106.
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Y.M., Erez O., Kusanovic J.P., Pineles B.L., Papp Z., Hassan S. Low maternal concentrations of soluble vascular endothelial growth factor receptor-2 in preeclampsia and small for gestational age. J Matern Fetal Neonatal Med., 2008. V. 21. P. 41 -52.
6. Maynard S.E., Min J.Y., Merchan J., Lim K.H., Li J., Mondai S., Libermann T.A., Morgan J.P., Sellke F. W., Stillman I.E., Epstein F.H., Sukhatme V.P., Karumanchi S.A. Excess placental soluble fms-like tyrosine kinase 1 (sFltl) may contribute to endothelial dysfunction, hypertension, and proteinuria in preeclampsia. J ClinInvest, 2003. V. 111. P. 649-658.
7. Tuffneil D.J., Shennan A.H., Waugh J.J., Walker J.J. The management of severe pre-eclampsia / eclampsia. London (UK): Royal College of Obstetricians and Gynaecologists, 2006. Mar. 11 p.
8. Zhou C.C., Ahmad S., Mi T., Abbasi S., Xia L., Day M.C., Ramin S.M., Ahmed A., Kellems R.E., Xia Y. Autoantibody from women with preeclampsia induces soluble Fms-like tyrosine kinase-1 production via angiotensin type 1 receptor and calcineurin / nuclear factor of activated T-cells signaling. Hypertension, 2008. V. 51. P. 1010-1019.
CLINIC-EPIDEMIOLOGICAL FEATURES AND WAYS OF PREVENTION OF IRON DEFICIENCY CONDITIONS IN PREGNANT WOMEN Mamadaliyeva M.M.1, Asrankulova D.B.2 Email: Mamadaliyeva17161@scientifictext.ru
'Mamadaliyeva Mehriyor Mansurbekovna — Assistant; 2Asrankulova Diloram Bahtiyarovna - Doctor of Medical Sciences, Professor, DEPARTMENT № ' OF OBSTETRICS AND GYNECOLOGY, ANDIJAN STATE MEDICAL INSTITUTE, ANDIJAN, REPUBLIC OF UZBEKISTAN
Abstract: the article presents a review of recent literature on an urgent global problem in obstetric and perinatal practice - iron deficiency anemia in pregnant women. This pathology, despite the introduction of modern methods of diagnosis, prevention and treatment, remains significant at the present time. It was found that among blood diseases in pregnant women, various forms of anemia account for 90%, of which 75-90% is iron deficiency anemia (IDA). Other forms of anemia are no more common than in the population of non-pregnant women.
Keywords: iron deficiency state, prevention, pregnant woman, clinical and epidemiological peculiarity.
КЛИНИКО-ЭПИДЕМИОЛОГИЧЕСКИЕ ОСОБЕННОСТИ И ПУТИ ПРОФИЛАКТИКИ ЖЕЛЕЗОДЕФИЦИТНЫХ СОСТОЯНИЙ У
БЕРЕМЕННЫХ Мамадалиева М.М.1, Асранкулова Д.Б.2
'Мамадалиева Мехриёр Мансурбековна — ассистент; 2Асранкулова Дилорам Бахтияровна — доктор медицинских наук, профессор, кафедра № ' акушерства и гинекологии, Андижанский государственный медицинский институт, г. Андижан, Республика Узбекистан
Аннотация: в статье представлен обзор литературы последних лет по актуальной мировой проблеме в акушерской и перинатальной практике — железодефицитной анемии у беременных. Данная патология, несмотря на внедрение современных методов диагностики, профилактики и лечения, остается значимой в настоящее время. Установлено, что среди болезней крови у беременных на долю различных форм анемии приходится 90 %, из которых 75—90 % составляет железодефицитная анемия (ЖДА). Другие формы малокровия встречаются не чаще, чем в популяции небеременных женщин.
Ключевые слова: железодефицитная состояния, профилактика, беременная женщина, клинико-эпидемиологическая особенность.
UDC 6'6.'55.'94.8:6'8.3-06
Relevance. According to the World Health Organization, the number of pregnant women who have been diagnosed with iron deficiency anemia reaches 20 million annually. Despite the organization of preventive programs in many developed countries, the level of IDA does not decrease, but, on the contrary, tends to increase by 12 times [2, 5].
