Rational control of arterial pressure during labor in women with arterial hypertension.

ABSTRACT

OBJECTIVES: Were to identify the advantages and disadvantages of different protocols of antihypertensive therapy in women with arterial hypertension during the process of labour and their effects on the labour progressing and perinatal complications. MATERIAL AND METHODS: 228 women who had childbirth in 2013-2018 in the Ternopil perinatal centre "Mother and Child" were surveyed. The study included full-term singleton pregnancies in cephalic presentation. According to the treatment program, women were divided into 4 groups Group 1 58 pregnant women who neglected treatment or had insufficient compliance; Group 2 57 pregnant women who used methyldopa and classic beta-blockers during pregnancy and labor; Group 3 57 pregnant women who received high selective beta-blocker with vasodilating properties nebivolol in addition to methyldopa; Group 4 56 healthy pregnant women with normal blood pressure and without other somatic pathology. RESULTS: Hypertension and inadequate hemodynamic control can become risk factors for higher incidence of low birth weight, prolonged or discoordinated labour, excessive blood loss during and after delivery. The program of treating hyper- tension in pregnant women with nebivolol hydrochloride provides sufficient control of blood pressure and helps to avoid blood pressure spikes or an excessive increase of systolic and diastolic blood pressure and heart rate during childbirth, which could endanger the mother's health. CONCLUSIONS: The treatment with nebivolol hydrochloride for women with chronic arterial hypertension during pregnancy and delivery allows to normalize the progress and duration of labour, decrease the incidence of low birth weight and the percentage of excessive blood loss during labour.