DIFFERENTIAL DIAGNOSIS OF HYPERTENSIVE DISORDERS IN PREGNANCY


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Abstract

Pregnant women with chronic arterial hypertension (CAH) have a more favorable prognosis than those with preeclampsia. In addition, the principles of treatment for preeclampsia and CAH are different. Objective. To develop a procedure for the differential diagnosis of hypertensive disorders in pregnancy. Subjects and methods. Examinations were made in 60 pregnant patients in the third trimester (20 with physiological pregnancy, 20 with CAH, and 20 with severe preeclampsia). Central hemodynamic parameters, oxygen status, and lactate levels were analyzed. Results. The most marked abnormal hemodynamic parameters were noted in pregnancy complicated by preeclampsia. The patients with hypertensive disorders were found to have arterialized venous blood, suggesting microcirculatory disorders. Discriminant analysis could obtain a decision rule to determine a diagnostic index. Conclusion. The timely and correct revelation of the causes of hypertensive disorders in pregnancy are of great importance for the use of adequate therapy and for the expediency of pregnancy prolongation.

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About the authors

Svetlana Vladimirovna Kinzhalova

Ural Research Institute of Maternity and Infancy Care, Ministry of Health of Russia

Email: sveking@mail.ru
Ph.D, head of research department of intensive care and resuscitation 620028, Russia, Yekaterinburg, Repina str. I

Ludmila Anatolievna Pestryaeva

Ural Research Institute of Maternity and Infancy Care, Ministry of Health of Russia

Email: pestryaeval@yandex.ru
Ph.D, head of research department of biochemical research methods 620028, Russia, Yekaterinburg, Repina str. I

Roman Aleksandrovitch Makarov

Ural Research Institute of Maternity and Infancy Care, Ministry of Health of Russia

Email: r_makarov_ekb@mail.ru
Ph.D, a senior researcher at research department of intensive care and resuscitation 620028, Russia, Yekaterinburg, Repina str. I

Nadejda Stepanovna Davydova

Ural State Medical University, Ministry of Health of Russia

Email: davidovaeka@mail.ru
MD, professor, head of the department of anesthesiology, intensive care and transfusion faculty for qualification improvement and professional retraining Yekaterinburg 620028, Repina str. 3, Russia

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