V.M. Baev

E.A. Vagner Perm State Medical University, 26 Petropavlovskaya Str., Perm, Russian Federation, 614990

Baev V.M. — D. Sc. (medicine), Professor of the Department of Anesthesiology, Resuscitation and Emergency Medical Care, tel. (342) 249-91-14, e-mail: VMBaev@Hotmail.com, ORCID: 0000-0001-9283-8094

 Objective ― to study the prognostic significance of arterial hypotension during pregnancy and childbirth. Results. The article presents data on the prevalence of arterial hypotension and its criteria. The characteristics of prenatal complications associated with hypotension for a pregnant woman are given: gestosis; abnormal location of the placenta on the posterior wall of the uterus; placenta previa; placental insufficiency; miscarriage; threat of abortion; untimely outflow of amniotic fluid; weakness of contractile activity of the uterus; premature delivery; prenatal mortality; the need for operative childbirth; purulent-septic complications; bleeding; pathology of the postpartum period. Prenatal complications for the fetus are considered: abnormal position, low weight, intrauterine growth retardation, intrauterine hypoxia, hypoxic brain damage, stillbirth. Conclusions. Low blood pressure in women should be diagnosed both before pregnancy and at the first visit to doctor during pregnancy. There is no experience of using sympathomimetic agents in pregnant women. Changing lifestyle and diet is recommended.

Key words: pregnancy, extragenital pathology, low blood pressure, prenatal pathology.

(For citation: Baev V.M. Prognostic significance of low blood pressure during pregnancy and childbirth (literature review). Practical Medicine. 2018)

REFERENCES

1. Milovanov A.P., Dobryakov A.V. The increasing importance of extragenital pathology in the structure of maternal mortality in Russia. Arkhiv patologii, 2018, no. 2, pp. 3-6 (in Russ.).
2. Kostyuk A.L. Extragenital pathology as a risk factor for urogenital disorders during pregnancy and after childbirth. Zdorovʹe zhenshchiny, 2015, no. 7, pp. 103-105 (in Russ.).
3. Gatina G.A., Makhmudova A.R., Yusupova D.G. Extragenital diseases of pregnant women of different age groups in Dagestan. Uralʹskiy meditsinskiy zhurnal, 2018, no. 3, pp. 54-57 (in Russ.).
4. Medvedʹ V.I., Danilko V.A., Kirilʹchuk M.E. On the feasibility and possibilities of reducing the number of cesarean sections in the clinic of extragenital diseases. Okhrana materinstva i detstva, 2016, no. 1, pp. 80-84 (in Russ.).
5. Owens P.E., Lyons S.P., O’Brien E.T. Arterial hypotension: prevalence of low blood pressure in the general population using ambulatory blood pressure monitoring. Journal of Human Hypertension, 2000, no. 14, rr. 243-247.
6. Dzilikhova K.M., Kaloeva Z.D., Dzgoeva M.G. et al. Features of central and regional hemodynamics in adolescents with primary arterial hypotension. Pediatriya. Zhurnal im. G.N. Speranskogo, 2013, no. 5, pp. 23-27 (in Russ.).
7. 2017 Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults. Journal of the American College of Cardiology. 2017. DOI:10.1016/j.jacc.2017.11.006.
8. Shardina L.A., Shardin S.A., Naydanova T.A. Hypotension: methods for studying blood pressure and clinical signs. Spravochnik poliklinicheskogo vracha, 2012, no. 11, pp. 13-17 (in Russ.).
9. Barsukov A.V., Vasilʹeva I.A., Karimova A.M. Arterialʹnaya gipotenziya: aktualʹnye voprosy diagnostiki, profilaktiki i lecheniya [Hypotension: current issues of diagnosis, prevention and treatment]. Saint Petersburg: EHLBI-SPb, 2012, 144 p.
10. Baev V.M., Agafonova T.Yu., Igumnova O.A., Kudryavtseva E.N. Idiopaticheskaya arterialʹnaya gipotenziya u molodykh zhenshchin [Idiopathic arterial hypotension in young women. Current problems of diagnosis, clinic and treatment]. Sovremennye problemy diagnostiki, kliniki i lecheniya. Palmarium Academic Publishing, 2018, 120 p.
11. Ridker P.M., Buring J.E., Rifai N. et al. Development and Validation of Improved Algorithms for the Assessment of Global Cardiovascular Risk in Women: The Reynolds Risk Score. Journal of JAMA, 2010, no. 5, pp. 610-620.
12. Kardiologiya: natsionalʹnoe rukovodstvo, red. E.V. Shlyakhto, 2-e izd., pererab. i dop. [Cardiology: national leadership. Ed. By E.V. Shlyakhto. 2nd ed., revised and enlarged]. Moscow: GEHOTAR-Media, 2015, 832 p.
13. Veyn A.M., Oknin V.Yu., Khaspekova N.B. The state of the mechanisms of vegetative regulation in arterial hypotension. Zhurn. nevrolog. i psikhiatr, 1996, no. 4, pp. 20-25 (in Russ.).
14. Nathan H.L., de Greeff A., Hezelgrave N.L. et al. Accuracy validation of the Microlife 3AS1-2 blood pressure device in a pregnant population with low blood pressure. Blood Press Monit, 2015, no. 5, pp. 299-302.
15. Pestrikova T.Yu., Ilʹinykh O.L., Yurasova E.A. Influence of arterial hypotension on the course of pregnancy and the outcome of childbirth. Dalʹnevostochnyy meditsinskiy zhurnal, 2012, no. 1, pp. 56-59 (in Russ.).
16. Shilyaeva N.S., Maksimova Yu.V., Makarov K.Yu. Changes in blood pressure during pregnancy. Meditsina i obrazovanie v Sibiri, 2008, no. 4, p. 11 (in Russ.).
17. Mezhdunarodnaya statisticheskaya klassifikatsiya bolezney i problem, svyazannykh so zdorovʹem. 10-y peresmotr. Vsemirnaya Organizatsiya Zdravookhraneniya [International Statistical Classification of Diseases and Problems Related to Health. 10th revision. World Health Organization]. Zheneva, 1995, no. 1, pp. 524-525.
18. Meléndez J.C., Mayordomo T., Sancho P., Tomás J.M. Coping strategies: gender differences and development throughout life span. The Spanish Journal of Psychology, 2012, no. 3, pp. 1089-1098.
19. Baev V.M., Koryukina I.P., Kudryavtseva E.N. et al. Low Blood Pressure in Young Women: Poor Concentration, Apathy, Acute Morning Weakness and Dyspeptic Symptom. Middle East Journal of Scientific Research, 2013, no. 4. DOI: 10.5829/idosi.mejsr.2013.14.4.2116.
20. Berezovskaya L.V. Khronicheskaya arterialʹnaya gipotenziya u molodykh zhenshchin s disfunktsiey reproduktivnoy sistemy: avtoref. dis. … kand. med. nauk [Chronic hypotension in young women with dysfunction of the reproductive system. Synopsis of dis. PhD med. sciences]. Ekaterinburg, 2005, 18 p.
21. McClure-Brown J.C. Survey of eclampsia clinical aspects. Report to the 7th Conference of the International Society of Geographical Pathology. London, 1960, pp. 542-556.
22. Friedman E.A., Neff R.K. Hypertension-hypotension in pregnancy. Correlation with fetal outcome. JAMA, 1978, no. 21, pp. 2249-2251. Doi: 10.1001/jama.1978.03280480041017.
23. Harsanyi Von J., Kiss D. Hypotonia in pregnancy. Zbl Gynakol, 1985, no. 107, pp. 363-369.
24. Steer P., Little M.P., Kold-Jensen T. et al. Maternal blood pressure in pregnancy, birth weight, and perinatal mortality in first births: prospective study. BMJ, 2004, no. 7478, p.1312. DOI: 10, 1136 / bmj.38258.566262.7C.
25. Kiselevich M.F., Kiselevich M.M., Kiselevich V.M. et al. The course of pregnancy and childbirth in women with arterial hypotension. Fundamentalʹnye i prikladnye issledovaniya v sovremennom mire, 2015, no. 9-3, pp. 5-10 (in Russ.).
26. Volkov A.E. Uterine hemodynamics during pregnancy complicated by arterial hypotension. Tavricheskiy mediko-biologicheskiy vestnik, 2016, no. 2, pp. 43-45 (in Russ.).
27. Subanova A.I. Features of the course of pregnancy in women living in the mountains of Kyrgyzstan on the background of arterial hypotension. Nauka vchera, segodnya, zavtra, 2016, no. 34, pp. 80-84 (in Russ.).
28. Goeschen K., Schmoldt V., Pluta M. et al. The effect of low blood pressure on venous function during and outside of pregnancy and therapeutic consequences. Geburtshilfe Frauenheilkd, 1985, no. 8, pp. 525-533.
29. Hohmann M., Künzel W. Low blood pressure in pregnancy. Z. Geburtshilfe Neonatol, 2007, no. 2, pp. 45-53.
30. Pestrikova T.YU., Ilʹinykh O.L., Yurasova E.A. Characteristics of the main indicators of the functioning of the placental complex in pregnant women with arterial hypotension. Dalʹnevostochnyy meditsinskiy zhurnal, 2012, no. 3, pp. 36-40 (in Russ.).
31. Fominova G.V. Nekotorye sposoby korrektsii zashchitno-adaptatsionnykh reaktsiy materi i ploda pri gipotonii beremennykh: avtoref. dis. … kand. med. nauk [Some methods for the correction of protective-adaptive reactions of the mother and fetus in pregnant women with hypotension. Synopsis of dis. PhD med. sciences]. Saransk, 2004, 19 p.
32. Warland J., McCutcheon H., Baghurst P. Maternal blood pressure in pregnancy and third trimester stillbirth: A case-control study. American Journal of Perinatology, 2008, no. 5, pp. 311-317.
33. Zhang J., Klebanoff M.A. Low blood pressure during pregnancy and poor perinatal outcomes: an obstetric paradox. Am. J. Epidemiol, 2001, no. 7, pp. 642-466.
34. Chen A., Basso O. Does low maternal blood pressure during pregnancy increase the risk of perinatal death? Epidemiology, 2007, no. 5, pp. 619-622.
35. Warland J. Low blood pressure. BMC Pregnancy and Childbirth, 2012, no. 12, p. A9.
36. Ciaroni S. Do we have to be scared of chronic constitutional low blood pressure. Rev. Med. Suisse, 2011, no. 285, pp. 544-547.
37. Lee W.E., Hotopf M. No prospective association between hypotension and idiopathic fatigue. Journal Psychosom Res., 2009, no. 67, rr. 153-158.
38. Staessen J.A., Fagard R.H., Lijnen P.J. Mean and range of ambulatory pressure in normotensive subjects from a meta-analysis of 23 studies. Journal Cardiol, 1991, no. 67, rr. 723-727.
39. Kremens D., Lew M., Claassen D., Goodman B.P. Adding droxidopa to fludrocortisone or midodrine in a patient with neurogenic orthostatic hypotension and Parkinson disease. Clin. Auton. Res, 2017, suppl 1, pp. 29-31.
40. Joseph A., Wanono R., Flamant M. et al. Orthostatic hypotension: A review. Nephrol Ther, 2017, suppl 1, pp. 55-67.
41. Kaloeva Z.D., Dzilikhova K.M., Dzgoeva M.G. et al. Balneotherapy in the complex treatment of patients with primary arterial hypotension. Pediatriya. Zhurnal im. G.N. Speranskogo, 2015, no. 2, pp. 77-82 (in Russ.).
42. Kudina E.V., Kudina E.V, Larina V.N. Tactics of management of women with arterial hypotension, depending on the clinical option. Problemy zhenskogo zdorovʹya, 2015, no. 3, pp. 66-70 (in Russ.).
43. Dolgova I.N., Starodubtsev A.I. Correction of cerebrovascular disorders in patients with idiopathic arterial hypotension. Vrach, 2013, no. 12, pp. 40-41 (in Russ.).
44. Baev V.M., Agafonova T.Yu. Positive clinical effects of M-anticholinergic in idiopathic arterial hypotension. Rossiyskiy kardiologicheskiy zhurnal, 2018, no. 2, pp. 102-106. DOI:10.15829/1560-4071-2018-2-102-106.