As a result of the study it was found that the appointment of complex drug prophylaxis in pregnant women with chronic hypertension helps to reduce the incidence of obstetric and perinatal complications, namely preeclampsia by 12 % (p˂0.05), disorders of uterine-placental circulation by 21.8 % (0.1˃р˃0.05) and, accordingly, reducing the incidence of fetal growth retardation in pregnant women by 19.2 % (p˂0.05).
In order to determine the level of risk factors for FGR, pregnant women with CAH were divided into groups taking into account the presence of FGR (n = 10) and without it (n = 51). Levels of PlGF, sFlt-1, ratio of sFlt-1 / PlGF (K), PIr and PIl, were considered as risk factors of development of FGR at pregnant women with chronic arterial hypertension. It was found that in pregnant women with CAH 1 and 2 degrees, who subsequently develop FGR in the first trimester of pregnancy (11-12 weeks of gestation) is determined by a decrease in PlGF levels, as well as an increase - sFlt-1 and K.
Prognostic markers of fetal growth retardation in pregnant women with chronic hypertension at 11-12 weeks of pregnancy are the level of PlGF ≤ 8.2 pg / ml, sFlt-1> 1802.59 ng / ml, the value of the coefficient K ≥ 95.36 units ., as well as the ratio of PG / PlGF> 7.21 units, E / PlGF> 138.53 units, HCG / PlGF ≥ 30.14 units.
When conducting a Doppler study of the uterine arteries at 11-12 weeks of gestation, in pregnant women with chronic hypertension, no significant changes in S/D and IR. In pregnant women with chronic arterial hypertension of PIr more than 1.84 units. (≥1.84 units) and PIl over 1.82 units. (≥1.82 units) develops FGR.
The proposed method using a scale of complex prognostic markers and the application of the algorithm of tactics of management of pregnant women with CAH, provides effective prediction and prevention of fetal growth retardation in pregnant women with chronic hypertension.
Scientific novelty of the obtained results. Extended scientific data on the features of the clinical course of pregnancy and childbirth in women with chronic hypertension, updated scientific data on the main risk factors for fetal growth retardation in this category of pregnant women.
Scientific data have been deepened, using a comparative analysis of markers of angiogenesis (placental growth factor and soluble fms-like tyrosine kinase-1) in pregnant women with chronic hypertension relative to healthy pregnant women.
The study of the relationship between the level of angiogenic factors and the hormonal profile in pregnant women at high risk of FGR was further developed.
For the first time, a method of using a scale of complex prognostic markers was developed and proposed, which provides effective prediction and prevention of fetal growth retardation in pregnant women with chronic hypertension.
