Hypertension in pregnancy: controversial issues of national and international guidelines

Чулков, В. С.; Мартынов, А. И.; Кокорин, В. А.

doi:10.15829/1560-4071-2020-4181

Cited by 11 publications

(2 citation statements)

References 53 publications

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“…Гипертензивные расстройства беременности служат общепризнанной причиной материнской заболеваемости и смертности, причем не только в развивающихся и бедных странах, но и регионах с хорошо развитой системой здравоохранения [2]. В США и ЕС, в которых материнская смертность наиболее низкая, ГРБ могут прогрессировать до гипертонической болезни и ассоциированы с риском ишемической болезни сердца и инсульта [3]. Кроме того, ГРБ увеличивают вероятность рождения маловесных детей и преждевременных родов [4].…”

Section: Introductionunclassified

Hypertensive Disorders of Pregnancy – Management Strategies in the Postpartum Period (Literature Review)

Rudaeva,

Kashtalap,

Marciyash

et al. 2023

Kompleks. probl. serdečno-sosud. zabol.

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HighlightsHypertensive disorders of pregnancy are associated with short- and long-term risks for the mother.We have identified several key points in the management strategy of this pathology in the postpartum period, which should contribute to the emergence of new directions in the prognosis and treatment modalities of this disease. AbstractThe article presents an analytical review of modern data on the treatment of hypertensive disorders of pregnancy (HDP) in the postpartum period. HDPs lead to maternal morbidity and mortality in developing and poor countries, and in regions with well-developed healthcare systems as well. HDPs can later progress into hypertension and are associated with the risk of coronary artery disease and stroke. Moreover, HDPs increase the likelihood of low-birth-weight babies and preterm births. The incidence of HDP is growing worldwide despite the implemented prevention methods: according to the Global Health Data Exchange, from 1990 to 2019 HDPs` incidence by 10.9% from 16.3 million to 18.08 million people. However, the introduction of universal approaches to prevention of complications made it possible to reduce mortality from HDP in the same period by 30.05%. The risk of hypertensive complications increases significantly in the postpartum period. Modern research confirms this – the likelihood of worsening HDP and the development of complications increases significantly in the first 24–48 hours after childbirth. About one third of cases of eclampsia occur in the postpartum period, of which almost half occur 48 hours after delivery. Stroke in women with HDP occurs in the postpartum period in half of the cases. Arterial hypertension (AH) in the postpartum period often requires an increase in doses of antihypertensive drugs, whereas after 3–6 months, many patients no longer need such therapy. During the first year after childbirth, the risk of progression of AH and the development of complications due to hypertension is increased, and remains so for many years. The feasibility of antihypertensive therapy in HDP today is beyond doubt, however, there are issues that require further study. They are related to the safety of prescribed drugs during lactation, and as a result, in many guidelines, antihypertensive therapy in the postpartum period is prescribed with reservations. Another problem is the relatively small number of RCTs directly assessing the effectiveness of antihypertensive therapy in the postpartum period.

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Section: Introductionunclassified

Hypertensive Disorders of Pregnancy – Management Strategies in the Postpartum Period (Literature Review)

Rudaeva,

Kashtalap,

Marciyash

et al. 2023

Kompleks. probl. serdečno-sosud. zabol.

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“…An increase in SBP of 140-159 mm Hg and/or DBP of 90-109 mm Hg is regarded as moderate hypertension, while SBP ≥160 mm Hg and/or DBP ≥110 mm Hg is considered severe hypertension. BP 160/110 mm Hg and more is one of the criteria for severe PE (Russian Society of Cardiology 2018; Chulkov et al 2020).…”

Section: Introductionmentioning

confidence: 99%

Physicians’ knowledge and preferences in tactics of management and rational pharmacotherapy of arterial hypertension in pregnant women (PHYGEST study)

Bontsevich¹,

Balamutova²,

Chukhareva³

et al. 2022

RRP

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Introduction: The issues of rational antihypertensive therapy in pregnant women are always extremely relevant, since high blood pressure in a pregnant woman is associated with serious risks for a mother and a fetus. The aim of the study: To determine the knowledge and preferences of physicians in the management of pregnant women with arterial hypertension. Materials and methods: A multicenter study was conducted in 2018–2021 using an anonymous questionnaire among 411 doctors from 8 regions of Russia. Results and discussion: The levels of knowledge and preferences of specialists in the issues of diagnosing and formulating a diagnosis of arterial hypertension and preeclampsia in pregnant women, prescribing basic and additional drugs for the treatment and prevention of hypertension were revealed, and the degree of compliance with the current clinical guidelines was assessed. Conclusion: Due to the insufficient level of knowledge of specialists, it is required to pay increased and special attention to this problem, strengthen control over compliance with clinical guidelines, and introduce it into postgraduate recommendations and continuing education programs.

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Hypotensive therapy in obstetric practice

Ziganshin,

Maksyutova

2024

Journal of obstetrics and women's diseases

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Arterial hypertension remains a leading cause of maternal morbidity and mortality while leading to significant economic costs in health care. Properly selected treatment tactics allow for prolonging pregnancy and levelling out various complications arising from the disease. However, there are still some questions about the effectiveness and safety of prescribed therapy due to possible side effects of the drugs. The aim of this study was to evaluate the efficacy and complications of hypotensive therapy during pregnancy, childbirth and the postpartum period. We analyzed the literature on eLibrary, Scopus, Cochrane Library, PubMed.

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Hypertension in pregnancy: controversial issues of national and international guidelines

Cited by 11 publications

References 53 publications

Hypertensive Disorders of Pregnancy – Management Strategies in the Postpartum Period (Literature Review)

Hypertensive Disorders of Pregnancy – Management Strategies in the Postpartum Period (Literature Review)

Physicians’ knowledge and preferences in tactics of management and rational pharmacotherapy of arterial hypertension in pregnant women (PHYGEST study)

Hypotensive therapy in obstetric practice

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