Platsentarnaya nedostatochnost' u beremennykh s gestatsionnoy arterial'noy gipertenziey i patogeneticheskiy podkhod k ee profilaktike

The study was aimed to the prevention the fetal complications in women with gestational hypertension (GAH) by the application of preventive pathogenetic treatment still at the preclinical stage of placental insufficiency (PI). Sixty pregnant women with GAH aged from 20 to 39 years were divided into 2 groups - experimental group and comparison group; 20 pregnant women without GAH were included in the control group. The following methods of evaluation were used: ultrasound, Doppler ultrasound, cardiotocography, and the definition of von Willebrand factor (vWF). Women in 1st (experimental) group have received sulodexide in combination with antihypertensive therapy and folic acid preparations. Despite the standard therapy, formation of GAH in women in the 2nd half of pregnancy was accompanied by increased vWF levels, development of hemodynamic disorders IA degree (76.6%), ultrasound signs of PI (63.3%), fetal hypoxia (43.3% ) with the development of fetal growth retardation (FGR) - in 30% of women. In women receiving sulodexide in the complex treatment, signs of PN observed to a lesser extent: the level of vWF was 46.5% lower, hemodynamic instability IA degree (63.3%), ultrasound signs of PI (23.3%), fetal hypoxia (10%), the development of FGR (6.6%) occurred significantly less often. The ratio of the risk of occurrence of complications in patients of the experimental group treated with sulodexide in relation to the comparison group was 0.37 for the PI (95% CI; 0.18-0.74), 0.23 for hypoxia (95% CI, 0.07-0.73) and 0.38 for FGR (95% CI, 0.20-0.72). Thus, sulodexide significantly reduces the risk of PI and fetal complications in women with GAH.

placental insufficiency, gestational hypertension, fetal growth retardation, sulodexide