Optimization of pharmacotherapy of gestational hypertension

Abstract

Hypertension in pregnant women disimprove the placental function, impairs fetal development and has an adverse effect on the condition of a woman. Usually dopegyt is used to treat gestational hypertension. However, it reduces the microcirculation of blood in the placenta, causing or increasing pre-existing placental dysfunction. Therefore, the aim of the research is to optimize the method of gestational hypertension pharmacotherapy in pregnant women with a set of infusion drugs including pentoxifylline, arginine hydrochloride with levocarnitine and reosorbilact to prevent fetoplacental dysfunction and perinatal pathology in this case. We examined 73 pregnant women, among whom we distinguished 3 groups: first group (n = 30) - pregnant women with GH, who, along with the basic therapy with dopegyt received a complex of infusion solutions (pentoxifylline, a solution containing arginine hydrochloride and levocarnitine, drug reosorbilact); second group (n=20) - patients with gestational hypertension who received only basic therapy with dopegyt; control group (n=23) - women with physiological pregnancy. Studies of the clinical effectiveness of the proposed treatment were evaluated by cases of prevention of perinatal pathology (intrauterine growth restriction of the fetus (IUGR), premature birth, etc.) and the results of clinical, laboratory and instrumental research methods. Criteria for inclusion in the study were: the presence of blood pressure >150/100 mm Hg, dopegyt, gestational age from 28 to 36 weeks, singleton pregnancy. Examination of pregnant women was performed using standard clinical, laboratory and instrumental (Doppler ultrasounds) research methods. The analysis of the obtained data was performed using the program "STATISTICA 5.5". Established that in patients who received our treatment regimen, there was a significant reduction in the development of placental dysfunction (OR 0.30, 95 % CI [0.12-0.74], p=0.009), fetal IUGR (OR 0.33, 95 % CI [0.12-0.96], p=0.042), acute fetal distress (OR 0.25, 95 % CI [0.075-0.83], p=0.02), weakness of childbirth (OR 0,19, 95 % CI [0.04-0.82], p=0.03), reducing the risk of perinatal CNS damage (OR 0.22, 95 % CI [0.05-0.99], p=0.049) and reducing the risk of cephalohematoma (OR 0.25, 95 % CI [0.075-0.83], p=0.024).