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Arterial hypertension in pregnant women

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Clinical importance of arterial hypertension in pregnant women is usually viewed through the prism of the influence of this pathology on the condition of mother and fetus. Being one of the major causes of maternal and perinatal mortality, arterial hypertension leads to vascular accidents, delay of intrauterine growth, prematurity, and much more. Sad as it may sound, but hypertension is the cause of 25% of all hospital admissions of pregnant women.

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 What is the phenomenon of "hypotensive action of pregnancy"?

the Absence of hypertensive disorders during pregnancy indicates a minimum risk of development of cardiovascular disease in the future, while gestational hypertension and preeclampsia increase the risk essencialna hypertension (4 times), myocardial infarction (2 times) and stroke in later life. That is clinically significant  arterial hypertension in pregnant women is as relevant a problem as for the pregnancy, but has significant specificity. First of all, note that during normal pregnancy the arterial blood pressure (BP) tends to decrease. Lower AD happens to the diastolic component in the first trimester and continues in another trimester, the reduction in systolic (SBP) and diazatricyclo (DBP) pressure - this phenomenon is called the phenomenon of "hypotensive action of pregnancy". Understanding this physiological process is important for the management of pregnant women with arterial hypertension in the anamnesis, because normalization of blood pressure in this period leads to an erroneous view of the absence of disease.

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there are the following categories of hypertension in pregnant women:

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  • hypertension, pre-existing (1? 5%), - high blood pressure before pregnancy or before 20 weeks of present pregnancy;
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  • Gestational hypertension (6? 7%) had pregnancy-induced high blood pressure after 20 weeks without proteinuria. In most cases, but not always, takes place 6 weeks after birth;
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  • Pre-eclampsia - pregnancy induced increased blood pressure after 20 weeks with proteinuria. Runs for 6 weeks after birth. Characterized by organ hypoperfusion;
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  • hypertension, which sushestvovala earlier, in conjunction with preeclampsia (United preclampsia) - the progression of the AD and / or the appearance of proteinuria after 20 weeks in boree pre-hypertension.

 

Translated by "Yandex.Translate": translate.yandex.ru.

Author: Artlife
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