Arterial hypertension can significantly impair the health of pregnant woman and often causes early development and progression of gestational and perinatal complications. Endothelial dysfunction is considered to be one of the pathogenetic mechanisms of the development of this pathological condition . The aim of the study was to evaluate the effect of different antihypertensive therapy programs in pregnant women with chronic arterial hypertension.
Materials and methods: 64 pregnant women with chronic arterial hypertension on 30-36 weeks of gestation were examined. For the clinical assessment of the pregnant women state there were considered: monitoring of the blood pressure, echocardiography, blood and urine analyses, proteinuria assessment. To evaluate the function of the endothelium, the modified D. Celermajer technique was used; to evaluate the functional state of the fetus cardiotocography (CTG) and the fetal biophysical profile (BPP) were used. Endothelin -1 concentration and the number of desquamated endotheliocytes in the blood serum were studied for the evaluation of biochemical markers of endothelial function.
Results of the study and their discussion: It was found that, in pregnant women with arterial hypertension during the initial stage there is a central and peripheral hemodynamics disorder, and its severity directly correlates with the severity of the endothelial dysfunction and an increased risk of gestational and perinatal complications.
Conclusions: Tight control of arterial hypertension with normalization of arterial pressure due to inclusion of nebivolol hydrochloride (highly selective beta-blocker with vasodilating properties) in the management program allows to prevent the progression of endothelial dysfunction and aggravation of hemocirculation disorders, including the mother-placenta-fetus system. This fact ultimately leads to normalization of Manning score (parameters of biophysical profile).