Experience in the management of pregnant women with hypertensive disorders

Background. Women who have hypertensive disorders during pregnancy are confirmed to be at increased risk of developing subsequent hypertension and cardiovascular disease. Since hypertensive disorders increase the risk of maternal and perinatal morbidity and mortality, timely and correct diagnosis, as well as the choice of an adequate management plan for such patients is essential to prevent severe complications.

Objective. To analyze maternal and perinatal outcomes in women with hypertensive disorders in order to optimize the management of pregnant women with these complications.

Materials and methods. A retrospective comparative study was conducted based on medical records from 2021 to 2023. Maternal and perinatal pregnancy outcomes were studied in 124 women with hypertensive disorders. Patients were divided into 2 groups: Group 1 – 64 pregnant women with chronic arterial hypertension, Group 2 – 60 pregnant women with gestational arterial hypertension.

Results. The findings suggest that the presence of chronic arterial hypertension and gestational arterial hypertension contributes to an increased incidence of adverse maternal and neonatal outcomes. Our results also confirm the least controlled arterial hypertension in pregnant women with gestational arterial hypertension, which requires prescription of two- or three-component antihypertensive therapy during pregnancy, labor and delivery and postpartum period. Perhaps, achieving the target blood pressure level on the background of antihypertensive therapy and its timely adjustment reduces the incidence of serious complications and undesirable outcomes of pregnancy for mother and fetus. Effective treatment of hypertensive disorders in pregnant women is indicated by the joint stay of mother and newborn in satisfactory condition after delivery.

Conclusion. The data obtained indicate the need to optimize the tactics of management of women with hypertensive disorders and represent a reserve for reducing the incidence of adverse maternal and neonatal outcomes of pregnancy. Achievement of target blood pressure level on the background of antihypertensive therapy and its timely correction reduces the incidence of serious complications and adverse maternal and fetal outcomes of pregnancy.

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