Objective to study features of a course of pregnancy at a preeclampsia of varying severity and to compare them with data of control group of a research for the last 5 years. Material and methods. 440 patients of fertile age with a preeclampsia of varying severity are inspected. 200 patients of similar age without preeclampsia made control group. Findings. Data of the conducted research showed that the number of patients with toxicosis of the pregnant woman, threat of abortion and an iron deficiency anemia was statistically significantly 23 times more in the main group, than in control. In the second half of pregnancy at every fourth patient with a moderate preeclampsia and at every second from heavy the threat of premature births was observed. In the analysis of data the number of patients with threat of premature births in the main group was statistically significant in 35 times more, than in control, values of this complication varied from 25,2% (a moderate preeclampsia) to 50,8% (heavy). Premature amotio of normally located placenta took place at 6 of 63 patients with a heavy preeclampsia against the background of high figures of arterial pressure and heavy anemia. Conclusion. Early diagnostics and treatment of complications of pregnancy at a preeclampsia will allow to improve the forecast for the forthcoming childbirth.

Background: Identification of complications of childbirth in preeclampsia will enable to improve perinatal outcomes in this group of women, as well as determine the criteria for early and timely diagnosis of these disorders in order to optimize obstetric tactics and terms of delivery. The aim of the study: The analysis of features of a course of childbirth in preeclampsia of varying severity at the present stage. Materials and methods: The clinical analysis of a course of childbirth in 440 patients of "fertile" age with preeclampsia (main group) was carried out. 200 patients of similar age without preeclampsia made up the control group. Results: Every fifth patient with "moderate" preeclampsia and every sixth in the control at birth had a uterine dysfunction amid premature amniotic fluid discharge and impaired fat metabolism. The number of premature births depended on severity of preeclampsia. In the "moderate" form, delivery was detected prematurely in every fifth patient, in the "severe" form in half, and in the control, in every fifteen. Every fourth patient with preeclampsia had an operative birth. With an increase in the severity of this pathology, the number of Cesarean sections increased, which were performed in 45 (11.9%) patients with a "moderate" form, in all patients with "severe" and in 24 patients (12%) in control. The main indications for surgery with "moderate" preeclampsia were abnormalities of labor, with "severe"placental insufficiency, in patients with controla clinically narrow pelvis. Conclusion: Timely diagnosis and treatment of preeclampsia will reduce the number of complications in childbirth, which optimizes obstetric tactics and significantly improves the long-term prognosis.

No abstract

Вопрос о причинах развития преэклампсии недостаточно изучен, поскольку он носит «многосторонний» характер и требует тщательной диагностики уже на «прегравидарном» этапе. Цель исследования-анализ причин, лежащих в основе патогенеза преэклампсии, по данным литературы. Проведен анализ 29 отечественных и 16 зарубежных литературных источников. Все причины развития преэклампсии делились на «социальные» и отражающие показатели соматического и репродуктивного здоровья. Сочетание 2-3 причин повышали риск развития «тяжелой» преэклампсии, а более 3-развитие эклампсии. Большинство ученых к отягощающим «социальным» причинам относили неблагоприятные условия труда, быта, плохое питание. Среди отягощающих причин анамнеза выделялись такие, как «низкий» паритет, заболевания сосудисто-почечного генеза. Основные причины преэклампсии, находящиеся в «социальной» и плоскости здоровья женщин требуют диагностики до наступления беременности. Однако данные меры должны носить глубокий системный характер и проводиться на «популяционном» уровне. Знание степени влияния каждой клинической причины может оказать существенную помощь практикующему врачу, как на этапе планирования беременности, так и в процессе принятия важных решений. ABSTRACT The question of the reasons of development of a preeclampsia is insufficiently studied as it has "multilateral" character and demands careful diagnostics already at a before pregnancy stage. A research objective-the analysis of the reasons which are the cornerstone of pathogenesis of a preeclampsia according to literature. The analysis of 29 domestic and 16 foreign references is carried out. All reasons of development of a preeclampsia were divided into the "social" and reflecting indicators of somatic and reproductive health. A combination of 2-3 reasons more than 3 increased risk of development of a "heavy" preeclampsia, and-development of an eclampsia. Most of scientists carried unfavorable conditions of work, life, bad food to the burdening "social" reasons. Were distinguished from the burdening reasons of the anamnesis such as "low" parity, diseases of vascular and renal genesis. The basic reasons of a preeclampsia which are in "social" and the planes of health of women demand diagnostics before pregnancy. However, these measures have to have deep system character and be carried out at the "population" level. Knowledge of extent of influence of each clinical reason can provide substantial assistance to the practicing doctor, both at a pregnancy planning stage, and in the course of adoption of important decisions.