TREATMENT OF ARTERIAL HYPERTENSION IN PREGNANT WOMEN

Abstract

ABSTRACT 
The  purpose  of this study was a  comparative  assessment  of the effect  of the 
selective  beta-1  adrenoblocker  metoprolol,  clonidine  and  methyldopa  on  the 
hemodynamic parameters of the mother and the condition of the fetoplacental complex. 
60 pregnant women with grade II hypertension and 20 healthy women were examined, 
compared  they differ in age and gestation period. The patients were divided into 3 
clinically equivalent groups, the first of which received metoprolol 50 mg 2 times a 
day  as  a  hypotensive  agent  (with  stabilization  of  the  figures  Blood  pressure  was 
switched to a maintenance dose of 25 mg / day), the second – clonidine at a dose of 
0.075  mg  2-3  times  a  day,  the  third  –  methyldopa  250  mg  2  times  a  day.  The 
effectiveness of treatment was assessed according to the data of echocardiography of 
the mother, additional plerometry of the fetal placental vessels, fetal cardiotocography, 
and  the  results  of  histological  examination  of  the  placentas.  In  the  treatment  of 
hypertension in pregnant women with hyperkinetic type of central hemodynamics , 
metoprolol  was  more  effective  than  clonidine  and  methyldopa  in  reducing  blood 
pressure, normalizing  increased the indicators  of the  central  hemodynamics  of the 
mother, restored blood flow in the fetoplacental system, increased the reactivity of the 
fetal cardiovascular system. Clinical effects of clonidine have been noted in patients 
current with hypokinetic type of central hemodynamics, methyldopa – with eukinetic 
type of blood circulation preferences. 
Antihypertensive  therapy  in  pregnant  women  with  hypertension  should  be 
differentiated  and  dependent  the  network  depends  on  the  type  of  central 
hemodynamics.