Cardiovascular consequences of great obstetrical syndromes

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Abstract

The great obstetrical syndromes (GOS) are a term that summarizes major obstetric complications from a pathogenesis perspective. It includes preterm labor, pre-labor rupture of membranes, pre-eclampsia, fetus small for gestational age (low birth weight), and other conditions. The pathogenesis of GOS includes immune and vascular elements, which, among others, determine its effects on the cardiovascular system. Preeclampsia is the most studied complication of pregnancy in terms of the development of cardiovascular complications, including arterial hypertension, impaired cardiac function, risk of cardiovascular events, and mortality. Fetal growth restriction and preterm birth are not accompanied by the development of critical organ dysfunction; however, the common pathogenesis determines the risk of future cardiovascular events. The cardiovascular risk in patients with obstetric complications is elevated even before pregnancy; therefore, the development of GOS may trigger the development of complications. Despite the existence of some evidence base on the consequences of GOS, patient follow-up is not organized, and a regulatory framework has not been developed. The Russian Federation has no regulatory framework for the inclusion of such patients in outpatient medical supervision. Early diagnosis and appropriate rehabilitation can minimize the risk of long-term sequelae.

Conclusion: The data presented in this review indicate a high incidence of cardiovascular events following obstetric complications. The development of a methodology, forms of implementation, and recommendations for rehabilitation based on interdisciplinary interaction and continuity can become a new direction for scientific research and organizational solutions to this important problem.

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About the authors

Nariman R. Akhmadeyev

Kazan State Medical University, Ministry of Health of the Russian Federation; City Clinical Hospital No. 16

Author for correspondence.
Email: akhmadeyevnr@gmail.com
ORCID iD: 0000-0003-0908-7256

Ph.D., Associate Professor, Department of Obstetrics and Gynecology named after Prof. V.S. Gruzdev; Head of Labor Department No.1

Russian Federation, Kazan; Kazan

Ildar F. Fatkullin

Kazan State Medical University, Ministry of Health of the Russian Federation

Email: fatkullin@yandex.ru
ORCID iD: 0000-0001-9673-9077

Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology named after Prof. V.S. Gruzdev

Russian Federation, Kazan

Larisa S. Fatkullina

Kazan State Medical University, Ministry of Health of the Russian Federation

Email: fatkullinalara@gmail.com
ORCID iD: 0000-0003-0361-2785

Ph.D., Associate Professor, Department of Obstetrics and Gynecology named after Prof. V.S. Gruzdev; Chief Freelance Specialist in Obstetrics and Gynecology of Kazan Department of Health of Ministry of Health of the Republic of Tatarstan

Russian Federation, Kazan

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