<p>Cilj: Svrha ovog istraživanja je da se odredi uticaj promena u funkciji, morfologiji i geometriji leve komore (LK) i odusustva očuvanog dnevno-noćnog profila krvnog pritiska (KP) na intrauterini zastoj u rastu fetusa (IUGR) i preterminsko završavanje trudnoće kod gestacijske hipertenzije (GH), reverzibilnost tih promena posle porođaja i povezanost GH sa prisustvom arterijske hipertenzije u porodici. Metodologija: U ovu studiju, koja je koncipirana kao prospektivna, uključeno je 90 trudnica, 30 normotenzivnih, 30 sa GH i dipping profilom KP i 30 sa GH i non-dipping profilom KP. Svim ispitanicama urađen je kompletan dvo-dimenzionalni, pulsni i tkivni Doppler ehokardiografski pregled i ambulatorni 24-h monitoring KP u trećem trimestru trudnoće i 6 nedelja posle porođaja. Rezultati i diskusija: U grupi trudnica sa GH značajno više su bili poremećeni parametri sistolne, dijastolne i globalne funkcije (EF, s’, E, A, E/A, E/e’, DTE, IVRT, IVCT, ET, Tei indeks, CO, CW, Ees), morfologije (IVSd, PLWd, RWT, masa miokarda, p<0,0005) i geometrije LK (abnormalna geometrija 67,7% vs 3,3% kod normotenzivnih, p<0,0005). Najizraženije promene bile su u podgrupi non-dippera. Posle porođaja registrovano je značajno popravljanje svih promenjenih ehokardiografskih parametara, a 96,7% ispitanica iz non-dipper podgrupe imale su očuvan dnevno-noćni ritam posle porođaja. U grupi sa GH utvrđeno je postojanje arterijske hipertenzije u porodici u 80% slučajeva u odnosu na 26,7% u kontrolnoj grupi (p<0,0005). Analizom rezultata utvrđeno je da su povećanje maksimalne vrednosti noćnog dijastolnog KP, indeksa mase miokarda i totalne vaskularne rezistence nezavisni prediktori IUGR-a, dok su povećanje prosečne vrednosti noćnog sistolnog KP i indeksa mase miokarda i smanjenje EF nezavisni prediktori preterminskog porođaja. Zaključak: Promene u funkciji i morfologiji leve komore i non-dipping profil KP kod GH imaju prognostički uticaj na pojavu IUGR-a i preterminsko završavanje trudnoće.</p> / <p>Objective: The purpose of this study was to determine the influence of changes in function, morphology, and geometry of the left ventricle (LV) and a non-dipping arterial blood pressure (BP) pattern on the intrauterine growth restriction (IUGR) and preterm delivery in pregnant women with gestational hypertension (GH), reversibility of these changes after delivery and connection between BP in family with GH. Methods: This prospective study included 90 pregnant women, 30 normotensive, 30 with GH and dipping BP pattern and 30 with GH and non-dipping BP pattern. All participants underwent a complete two-dimensional, pulsed and tissue Doppler echocardiography and 24-h ambulatory blood pressure monitoring in the third trimester and 6 weeks after delivery. Results and discussion: Participants with GH had more impaired parameters of the LV systolic, diastolic and global function (EF, s’, E, A, E/A, E/e’, DTE, IVRT, IVCT, ET, Tei index, CO, CW, Ees), morphology (IVSd, PLWd, RWT, myocardial mass, p<0,0005) and geometry (abnormal geometry 67,7% vs 3,3% in normotensive, p<0,0005). The greatest changes were noticed in non-dippers. All changed echocardiographic parameters became improved, while 96,7 % non-dipper participants became dipper after delivery. Arterial hypertension in family was present in 80% women with GH vs 26,7% in normotensive (p<0,0005). Analyses revealed that maximum night-time diastolic BP, mass index and total vascular resistance were identified as independent predictors of IUGR. Average systolic night-time BP, mass index and EF were identified as independent predictors of preterm delivery. Conclusion: Changes in LV function, morphology and geometry and a non-dipping pattern of BP in GH predicts IUGR and preterm delivery.</p>
| Identifer | oai:union.ndltd.org:uns.ac.rs/oai:CRISUNS:(BISIS)94139 |
| Date | 29 June 2015 |
| Creators | Ilić Aleksandra |
| Contributors | Kopitović Vesna, Pavlović Katica, Čemerlić Ađić Nada, Ivanović Branislava, Panić Gordana, Dejanović Jadranka, Grujić Zorica |
| Publisher | Univerzitet u Novom Sadu, Medicinski fakultet u Novom Sadu, University of Novi Sad, Faculty of Medicine at Novi Sad |
| Source Sets | University of Novi Sad |
| Language | Serbian |
| Detected Language | Unknown |
| Type | PhD thesis |
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