[PECULIARITIES OF PREGNANCY COURSE AND DELIVERY OUTCOMES IN WOMEN WITH VARIOUS FORMS OF ARTERIAL HYPERTENSION]

The aim of the study was to compare blood pressure levels at specific periods of pregnancy, antihypertensive treatment regimens, pregnancy and childbirth outcomes in women with CAH and GAG to develop a differentiated approach to the management of pregnant women with hypertension. A prospective cohort study was conducted on the dynamic observation of 110 pregnant women with hypertension on the basis of perinatal centers №1 and №3 of Nur-Sultan (Kazakhstan) in 2018-2019. The main method for monitoring blood pressure was an office measurement, which was carried out in a perinatal center with an Omron HEM-FL31-E apparatus in compliance with the ESC 2018 recommendations. The comparative analysis included indicators of average office blood pressure during gestation: 14-16, 20-22, 28-30, 34-36 weeks of pregnancy, as well as 2 weeks, 2 and 3 months after delivery. The results of the study show that despite constant monitoring of blood pressure and antihypertensive therapy, blood pressure in the main group is statistically significantly higher than in the control group. Against the background of higher levels of SBP and DBP in pregnant women with CAH, with the regular use of antihypertensive therapy, more unfavorable outcomes of pregnancy and childbirth were observed compared with the group of pregnant women with GAG. Despite the fact that the frequency of complications such as PE, prenatal discharge of amniotic fluid, and atonic bleeding in pregnant women with GAG was more common, outcomes of labor are more unfavorable for pregnant women with CAH. Violation of the BMD (IA, IB, II degrees), distress, the birth of a small fetus were more common in the group of pregnant women with CAH. While the frequency of pregnancy complications is relatively the same in both groups, the outcome of labor is more favorable in the group of pregnant women with GAG. Perhaps this is due to a violation of the BMD in the group of pregnant women with CAH, which subsequently affects a less favorable outcome of the birth.