[Anaesthesia in abdominal delivery in pregnant patients with hypertension].

A differentiated administration of calcium antagonists in preoperative preparation of pregnant patients with hypertension enabled the conversion of circulatory system state to "normal pregnancy range": a conversion of hypokinetic (including the HES solution infusion) and hyperkinetic types of haemodynamics to eukinetic one, with the decrease of total peripheral resistance and myocardium need for oxygen, autonomous nervous system state to physiological sympathicotonia. Evidence shows that continued intra-operative treatment including tranexamic acid enables to maintain those results during the surgery. In postoperational period, the clinical manifestations of SIRS in patients who has received the mentioned therapy were marked less then in control group, and the newborns have a higher Apgar score.

[Optimization of anesthetic service during abdominal delivery of pregnant women with gestosis].

Differential preoperative preparation of pregnant women with gestosis, by using calcium antagonists is an effective preventive measure against a circulatory hyperdynamic response to transportation to the operating suite. In pregnant women who had all hemodynamic types at baseline, the eukinetic type achieved during the preparation is retained. The patients with gestosis who did not receive calcium antagonists were found to have a circulatory hyperdynamic response with increased myocardial oxygen uptake (during surgery in particular). The use of calcium antagonists, ketonal, tranexamic acid, and hydroxyethyl starch-130/04 solution in the anesthetic appliance promoted the preservation of eukinetic hemodynamics in all those operated on, without increasing myocardial oxygen demands. The better reaction of the circulatory system and myocardial oxygen demands to surgical injury (the second mediatory wave of the systemic inflammatory response syndrome) correlated with higher neonatal Apgar scores in this category of puerperas with gestosis.

[Anesthetic service and the postoperative period in pregnant women with gestosis].

The paper analyzes the results of using in the anesthetic maintenance of pregnant females with gestosis the algorithm of preventing possible impairments in the development of the general adaptation syndrome in response to pregnancy and surgical labor. Calcium antagonists (eliminating dysfunction of secondary calcium messenger), ketonal, and tranexamic acid (which inhibiting a number of pain and inflammation mediators), and hydroxyethyl starch-130/04 solution (regenerating the endothelium) were administered to prevent the clinical manifestations of the intraabdominal compartment syndrome, ischemia-pefusion, and the second wave of the systemic inflammatory response syndrome in response to surgery. The differential use of the above agents at all stages of anesthetic maintenance in pregnant women with gestosis promoted the postoperative preservation of the most efficient eukinetic hemodynamics and physiological sympathicotonia and the elimination of water metabolic disturbances more early than in the control puerperas. A more physiological postoperative course in the study group puerperas called for much less pharmacotherapy, which created more favorable conditions for postoperative maternal-neonatal contact (feeding, etc.).