arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2021-27-2-146-169arthyper-1938Research ArticleСтатьиArticlesДиагностика и лечение гипертензивных состояний беременностиDiagnosis and treatment of hypertensive disorders of pregnancy: a narrative reviewhttps://orcid.org/0000-0002-3920-8234ГайсинИ. Р.GaisinI. R.

Гайсин Ильшат Равилевич — профессор кафедры госпитальной терапии с курсами кардиологии и функциональной диагностики ФПК и ПП ФГБОУ ВО Ижевская ГМА Минздрава России

ул. Ленина, д. 87б, Ижевск, 426009

Ilshat R. Gaisin, MD, PhD, DSc, Professor, Department for Internal Diseases with the Courses of Cardiology and Functional Diagnosis

87b Lenina str., Izhevsk, 426009 Russia

igaisin@mail.ruhttps://orcid.org/0000-0002-2360-6182ИсхаковаА. С.IskhakovaA. S.

Исхакова Альфия Сабитовна — врач-кардиолог отделения артериальной гипертонии специализированной поликлиники БУЗ УР «Республиканский клинико-диагностический центр» Минздрава УР

Ижевск

Alfiya S. Iskhakova, MD, Cardiologist, Outpatient Department for Hypertension

Izhevsk

ishakovaalfia@yandex.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Ижевская государственная медицинская академия» Министерства здравоохранения Российской ФедерацииРоссияIzhevsk State Medical AcademyRussian FederationБюджетное учреждение здравоохранения Удмуртской Республики «Республиканский клинико-диагностический центр» Министерства здравоохранения Удмуртской РеспубликиРоссияClinical Diagnostic Centre of the Udmurt RepublicRussian Federation202128122020272146169Copyright © Гайсин И.Р., Исхакова А.С., 20212021Гайсин И.Р., Исхакова А.С.Gaisin I.R., Iskhakova A.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/1938

Проведен обзор литературы по классификации, диагностике и лечению гипертензивных состояний беременности и раннего послеродового периода (хронической артериальной гипертензии (АГ), гестационной АГ, преэклампсии (ПЭ)), представленной различными обществами кардиологов и акушеров-гинекологов. Рассматривается международно согласованное широкое определение ПЭ, предложенное Международным обществом по изучению гипертензии при беременности (ISSHP) в 2018 году и поддержанное Международной федерацией гинекологии и акушерства (FIGO) в 2019 году, методы ее прогнозирования и профилактики. Рассматриваются все варианты лечения умеренной и тяжелой АГ у беременных. Приводится новая классификационная система лекарств при беременности и лактации PLLR (Правило маркировки лекарств при беременности и лактации) FDA (2015). Представлены лечебные цели артериального давления (АД) при АГ у беременных женщин и пороговые значения АД у беременных, при которых необходимо начинать лечение АГ. Приведены факторы риска, причины, клинические проявления, диагностические исследования и медицинская помощь при неотложных гипертензивных состояниях беременности. Приводится доказательная база, свидетельствующая о повышенном материнском и неонатальном риске АД ≥ 130/80 мм рт. ст. при беременности как нового критерия АГ Американской коллегии кардиологии и Американской ассоциации сердца ACC/AHA 2017 года.

The paper overviews classification, diagnosis and treatment of hypertensive disorders of pregnancy and early postpartum period (chronic hypertension (HTN), gestational HTN, pre-eclampsia) provided by different societies of cardiology and obstetrics and gynecology. The definition of pre-eclampsia offered by the International Society for the Study of Hypertension in Pregnancy (ISSHP) in 2018 and supported by the International Federation of Gynecology and Obstetrics (FIGO) in 2019, its screening and prevention are considered. All treatment options of moderate and severe HTN in pregnancy are reviewed. A new US Food and Drug Administration (FDA) classification system of drug therapy for pregnancy and lactation Pregnancy and Lactation Labelling Rule (PLLR, 2015) is presented. Treatment goals of HTN and blood pressure (BP) thresholds in pregnancy as well as risk factors, causes, clinical presentation, diagnostic workup and management of hypertensive emergencies in pregnancy are provided. We discuss the evidence of BP ≥ 130/80 mmHg as a factor of high maternal and neonatal risks proposed by the American College of Cardiology/American Heart Association (2017) as the HTN criteria in pregnancy.

гипертензивные расстройства беременностихроническая и гестационная гипертензияпреэклампсияклассификацияпрофилактикалечениеhypertensive disorders of pregnancychronic and gestational hypertensionpre-eclampsiaclassificationpreventiontreatmentReferencesAmerican College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of obstetricians and gynecologists’ Task Force on hypertension in pregnancy. Obstet Gynecol. 2013;122(5):1122–1131. doi:10.1097/01.AOG.0000437382.03963.88American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of obstetricians and gynecologists’ Task Force on hypertension in pregnancy. 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The authors declare that there are no conflicts of interest present.