Features of pregnancy and delivery in patients with pregnancy-induced hypertension

Abstract

Pregnant women with hypertensive disorders have a high risk for premature birth and early delivery due to the increased severity of hypertension associated with low effect of treatment. Vaginal birth in patients with hypertensive disorders are often complicated by premature rupture of membranes, labor abnormalities, abnormal blood loss. Emergency abdominal delivery is performed together with complex intensive therapy. A common approach to the management of pregnancies with mild and moderate forms of hypertension is treatment associated with prolongation of pregnancy. Therapeutic and protective regimen in childbirth is created by phased long-term epidural analgesia. Indications for induced delivery - I-II degree of nephropathy in the absence of a positive therapeutic effect for 1-2 weeks. Regarding to severe forms of hypertensive disorders, many researchers tend to think of the need for early delivery, to avoid complications. At the same time, early delivery often leads to birth with premature fetus, which contributes to worsening of perinatal outcomes in patients with hypertensive disorders. Currently the possibility of conservative management of pregnant with hypertensive disorders at the gestation term of less than 32 weeks using glucocorticoids may significantly improve perinatal outcomes. Conservative management is only possible in large clinical settings with careful selection of patients. Currently, there are different approaches to the selection of methods and timing of delivery in hypertensive disorders. The optimal strategy is based on a differentiated approach that takes into account the severity of hypertensive disorders and the probability of complications for mother and fetus. At the same time, the diversity of the pathogenesis of hypertensive disorders determines the presence of different variants of its clinical manifestations, clinical course and complications, making it difficult to properly assess its severity.