[Renal and uterine hemodynamics in pregnant women with hypertension]

To study gestational alterations of renal and uterine hemodynamics, their relationships with systemic and intracardiac hemodynamics in pregnant women (PW) with essential hypertension (EH).

Echocardiography, ultrasound dopplerography of renal and uterine arteries, roll-over test were made in the course of trimester II-III and 3 months after the delivery in 48 PW with EH degree 1-2 and control 20 healthy PW. Hemodynamic parameters in pregnancy were compared to postpartum ones. The latter were supposed to be basal.

Changes in systemic and intracardiac hemodynamics in EH and control women were in many respects similar but systolic blood pressure in EH changed insignificantly, minute volume increased owing to increased heart rate. PW with EH of the second degree have in the III trimester more frequent positive roll-over test this evidencing for high pressor reactivity of the vascular system. PW with EH showed higher speed of the blood flow in the renal arteries in unchanged resistance. With growing gestation time the resistance of the uterine arteries declined. The resistance of the main stem of the renal artery went up in enhanced cardiac contraction regardless of total peripheral vascular resistance (TPVR). Blood flow in the uterine arteries worsened in elevation of arterial pressure, TPVR, lowering of the heart rate and systolic function of the heart. Renal and uterine hemodynamics were independent.

Hemodynamic changes in control and EH PW were similar in many respects but higher arterial pressure, abnormal systolic function of the left ventricle, bradycardia disturb uterine blood flow. Renal circulation was independent of systemic and intracardiac hemodynamics and is unrelated to changes in the uterine circulation.