Crucial approaches to diagnostics and anaemia treatment in pregnant women with heart failure at the extragenital pathology clinic

Abstract

W ithin the last twenty years a range of problems and their nature, the specialists of the High Risk Pregnancy Department are facing, has signifi cantly increased.For a number of years the congenital heart diseases and a part of the congenital heart di seases were considered to be a contraindication for getting pregnant and carrying of a pregnancy. Today, a consensus among cardiac surgeons, cardiologists, and obstetrician-gynecologistshas been reached: the most of such patients will have an opportunity to carry the pregnancy and to deliver a baby without health damage subject to adequate assessment of cardiac reserve, peculiarities of haemodynamics, and proper psychological and medical supervision.In modern perinatology and at thehigh risk pregnancyclinic a great attention is paid to stratifi cation of «cardiac events» risks and perinatal complications. A great contribution to this was made by development and practical use of CarPreg and ZAHARA risk scales; prediction is defi ned by a score method and includesassessment of a heart disease type, availability and a degree of circulatory ineffi ciency, a degree of pulmonary hypertension, and hypoxemia intensity. These are the factors that aggravate the prediction, cause pregnancy complications and problems withphysiological fetal development. The main reason in forming obstetric and perinatal complications is due to prolonged hypoxia and heart failure in women with congenial heart diseases (CHD) [6,7].Taking into consideration signing of WHO Resolution on Protecting reproductive rights by our country, it is necessary to ensure the rights ofwomen with severe somatic and neurologic pathology such as the right toobtain adequate information concerning their health state and possible eff ect of the present pathology on a gestational process and future baby; to have an access to safe, effi cient, inexpensive, and aff or dable birth control methods up to their choice; to have access to relevant public health services ensuring safe pregnancy and labour to every woman, as well as arrangement of the best opportunities for married couples to have a healthy child.Taking into account the foregoing, the necessity to hospitalize pregnant women with the most severe diseases to the Department of Obstetric Problems in High Risk Pregnancy in the Institute of Pediatrics, Obstetrics, and Gynecology of NAMS of Ukraine, is performed in compliance with the regionalization principles toperinatal care in Ukraine, as well as an extension of modern diagnostics and treatment methods, prevention of perinatal complications. Thus we need to work out an approach to each pregnant woman without modern clinical practice guidelines for a number of nosological forms (including the cases of oncology pathology, severe cardiovascular pathology, etc.). It presupposes search of new approaches to solve both common and individual clinical cases. CARDIOVASCULAR PATHOLOGY AND ANEAMIAAneamia can be a cause of chronic heart failure (CHF) and its result. Today it is considered that pathogenesis of aneamia associat...