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академия им. С.И. Георгиевского» Крымского федерального университета им. В.И. Вернадского, Симферополь, Россия В настоящем обзоре рассмотрены современные представления о роли мочевой кислоты в патогенезе преэклампсии, результаты исследования ее показателей при гипертензивных нарушениях, сопровождающих беременность, а также обоснование целесообразности использования мочевой кислоты в качестве маркера преэклампсии и ее осложнений. Изучение динамики показателей мочевой кислоты при гестационной гипертензии позволит выявить потенциальные возможности ранней диагностики преэклампсии и улучшить качество ее лечения.

Background. Proteinuria is one of the most commonly diagnosed symptoms of gestational hypertensive disorders. Its values are important not only for the diagnosis of preeclampsia, but also correlate with a high probability of developing eclampsia, HELLP syndrome and unfavorable perinatal outcomes, and also indicate the development of kidney damage after delivery. Objectives. To assess the relationship of proteinuria during pregnancy and childbirth for mother and fetus in patients with preeclampsia when admitted to hospital in the Republic of Crimea from 2014 to 2018. Materials and methods. We performed a retrospective chart review of 149 patients with proteinuria in which pregnancy was complicated by preeclampsia. The study was conducted at admission of patients to hospital. According to the severity of proteinuria, the patients were divided into 2 groups - with moderate and severe proteinuria. The frequency of maternal and fetal complications, anthropometric indicators of mothers, their somatic diseases, and obstetric history were investigated as responses. Results. Patients with severe proteinuria, registered at admission to the hospital, were characterized by a younger age and lower body mass index versus patients with moderate proteinuria. The presence of severe proteinuria versus moderate proteinuria was more often observed in primigravida and nulliparous. Obesity and kidney pathology were more common in the moderate proteinuria group and among patients with severe proteinuria, cardiovascular diseases. The risk of complications of preeclampsia, as well as the likelihood of prematurity and respiratory distress in newborns were higher in the group of patients with severe proteinuria. Conclusions. The presence of severe proteinuria in patients with preeclampsia on admission to the hospital was characterized by a higher frequency of adverse outcomes for the mother and fetus than in the group with moderate proteinuria.

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The review discusses the possibilities of predicting preeclampsia and its complications, modern criteria for the diagnosis of gestational hypertensive disorders and tactics of their intensive therapy. Particular attention was devoted on the anesthetic management for cesarean section in a woman with preeclampsia and its complications. The information proposed in the review makes it possible to define a unified terminology and form unified evidence-based interdisciplinary approaches to the diagnosis and treatment of preeclampsia, which will improve maternal and fetal outcome.