Антропофизиологический взгляд на адаптацию кровообращения при беременности как циркуляторную основу преэклампсии

Abstract

An idea is based on adaptation of circulation of blood in pregnancy, coming from basic biological quality of man as straight-walking creature and value of tension of adjusting of the cardiovascular system (СVS) on the gravitational (hydrostatical) factor of circulation of blood in the haemodynamic providing physiological (PhP) and pathological pregnancy (PP). Observation condacted in 245 pregnant (with PP in 114 and with PaP in 131 woman), for 114 even-aged unpregnant and 179 men group of comparison. Typology description of dynamic organization of the circulator status of the cardiovascular system is examined, basis of which is a pumping function of heart at antropophysiological ratio (АPR) of cardiac output (CO) standying and lying - from the hypokinetic status with a decline of CO standing lower then 94% (I type), eukinetic status with absence of distinctions of CO (II type) and to the hyperkinetic status with an increase of CO standing more than 106% (III type). Except АPR, the pumping function of heart was estimated by CO and cardiac index (CI) according to body weight. As a system estimation of СVS and pumping function of heart, the appearance (stake in % on a selection) of the hemodynamically identified circulator syndromes of heart failure (НF) were used. Description of the circulator state of СVS is carried out on basic modes of blood pressure - hypotonic, normotonic and hypertensive. Expressive distinctions between pregnant and unpregnant, PP and PaP on descriptions of pumping function of heart - CO, CI, АPR, НF is examined as a display of antigravity tension of СVS in the conditions of straight-walking, in which pregnancy mainly (sitting. upright, walking)is spent and which synergistically increase tension of СVS. The marker of tension of haemodynamic alteration is a transition on the cardiac output (CO) to the hyperkinetic state in position from standing to lying - to III type of dynamic organization of the circulator state of СVS and system hyperresistance of arterial vessels, and by the predictor of insufficiency of adaptation of СVS - heart failure syndrome (HF) displays mostly in the position upright by perfusion type, combining with circulatory syndromes limiting adaptive possibilities of arterial circulation, especially abdominal and pelvic. Hemodynamically identified HF, as the most early preclinical circulatory form, is examined as trigger of formation of dynamic organization of the circulatory state of СVS, corresponding to the hypertensive state, including one in pregnancy.