The fetal status during anticoagulant therapy in pregnant women with preeclampsia

Objective. To study fetal regulatory systems in pregnant women with preeclampsia (PE). Subject and methods. Ninety-four patients with PE were examined; 46 of them received daily bemiparin 2500 U in addition to antihypertensive therapy. The investigators examined fetal heart rate variability by noninvasive electrocardiographic readings, as well as the phase portraits of umbilical venous blood flow in all the examinees. Results. In the patients with PE, fetal health worsening was ascertained to be accompanied by a reduction in all fractal components of heart rate variability with a relative preponderance of central sympathetic circuit. As fetal distress progressed, there was an increase in the role of maternal slow-wave processes in the regulation of umbilical venous hemodynamics, as well as depletion of intrinsic phlebotonic mechanisms, which enhanced the passage of a pulsation wave along the umbilical vein. The use of bemiparin increased the intensity of fetal vagal tone, which was associated with cardiorespiratory synchronization and higher maternal regulatory influences. Conclusion. The use of bemiparin in pregnant women with PE could optimize the autonomic nervous system regulation of hemodynamic processes in the fetus, which was attended by a relatively recovery of respiratory sinus arrhythmia and a levelling of hypersympaticotonia, by improving the fetal myocardial state and optimizing umbilical venous hemodynamics.

preeclampsia, thrombophilia, fetal regulatory systems, umbilical venous blood flow, bemiparin