Petruniak R. Peculiarities of pregnancy and labor, obstetric management of women with obesity and arterial hypertension

An examination of 558 pregnant women has been established, the women with combined pathology - obesity and arterial hypertension, are at high risk due to complications during pregnancy and childbirth in preeclampsia (32,2 %), interrupting pregnancy (45,8 %), placental dysfunction (45,8 %) and operative delivery (16,1 %). In newborns from mothers with obesity and hypertension observed significantly higher frequency of hypoxic CNS lesions (38,2 %), respiratory distress syndrome (13,6 %) and immaturity (11,6 %). Development of placental dysfunction in women with obesity and arterial hypertension caused by excess activation of lipid peroxidation decreasing of antioxidant activity, development of arherogenic type II A and II B od dyslipidemia, hyper- or hypodynamic hemodynamic syndrome at bradi-diastolic or systolic-diastolic type in 24-hour blood pressure monitoring and manifesting by dopplerometric disturbances in the fetal-placental circulation, significantly decreasing of estriol and placental lactogen level. The proposed program of management and treatment of pregnant women with obesity and arterial hypertension was effective in 84,5 % of patients and allows to significantly reduce the incidence of peri- and antenatal complications (p <0.05).