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THE ROLE OF ARTERIAL HYPERTENSION IN THE DEVELOPMENT
OF STROKE IN PREGNANT WOMEN.
Khasanova Sh.B.
Asrankulova D.B.
Nadjmitdinov O.B.
Andijan State Medical Institute
https://doi.org/10.5281/zenodo.13859737
Currently, special attention is paid to the study of risk factors,
improvement of diagnostics and treatment of cardiovascular diseases. It has
been established that arterial hypertension (AH) makes the main contribution to
the structure of this pathology. It has been proven that AH can act as a risk factor
for cerebrovascular diseases. AH is of particular importance during pregnancy
and in the postpartum period, since AH during pregnancy remains the leading
cause of maternal and child morbidity and mortality worldwide. In the available
scientific literature, there are only a few works devoted to AH-associated
nervous system lesions in pregnant women. In this regard, the aim of our review
was to analyze the role of AH in the development of cerebrovascular diseases
during pregnancy. It has been shown that with AH in pregnant women, strokes
occur 5.2 times more often than in pregnant women with normal blood
pressure.
The decisive role of AH in the development of stroke is convincingly
shown in a specific work. In a study that included 81,983,216 hospitalizations
during pregnancy between 1994 and 2011, 31,673 were strokes (3,8 per 10,000
cases), of which 9,890 were diagnosed with hypertension. During this time
period, an increase in strokes against the background of hypertension during
pregnancy was noted from 0,8 to 1,6 per 10,000. Stroke with hypertension was
more common in women aged 25 to 35 years (4,617 cases – 46,7%). It was
shown that with hypertension in pregnant women, strokes occur 5.2 times more
often than in pregnant women with normal blood pressure. The presence of PE
and eclampsia increases the risk of stroke by 7-9 times. The incidence of stroke
during pregnancy varies from 4,2 to 210 per 100,000 pregnancies. Such
differences in epidemiological indicators are apparently explained by the
difficulties of differential diagnostics during pregnancy. It should be agreed with
the opinion that a full examination of a patient with suspected stroke and
interpretation of the obtained results may be difficult against the background of
pregnancy
The risk of stroke increases from the third trimester of pregnancy to six
weeks of the postpartum period. In pregnant women with hypertension,
MODELS AND METHODS IN MODERN SCIENCE
International scientific-online conference
144
changes occur in the hemostasis system, which leads to the formation of arterial
and venous thrombosis of the brain. The presence of preeclampsia (PE)
increases the risk of stroke by 7-9 times. Endothelial dysfunction is considered
one of the leading links in the pathogenesis of PE. The study of biologically active
substances during pregnancy complicated by PE revealed an increase in
antiangiogenic factors and a decrease in angiogenic factors. Thus, to prevent the
development of cerebrovascular diseases in pregnant women with
hypertension, it is necessary to identify prehypertension in women of
childbearing age, improve methods of treating hypertension, and enhance
neuroprotective processes, which requires an interdisciplinary approach to the
diagnostic and treatment process with the participation of an obstetrician-
gynecologist, therapist, cardiologist, and neurologist.
