[Pathogenesis of systemic hemodynamic disorders and choice of optimal obstetrical strategy in pregnant patients with gestosis].

A total of 810 pregnant women were examined in order to elucidate the pathogenesis of hemodynamic disorders in gestosis. The main group consisted of 460 patients with gestosis of different severity and the control group included 150 women with uneventful pregnancy. Central and regional hemodynamics in normal pregnancy were studied in detail by modern diagnostic methods (echocardiography and dopplerometry) and the relationship between the detected shifts and the function of the utero-placento-fetal circulation was shown. The predominant type of central hemodynamics in gestosis is the hypokinetic. Disorders in renal and cerebral circulation contribute to the pathogenesis of severe gestosis. Pathogenetic variants of hemodynamics shifts in gestosis are analyzed and recommendations on the follow-up of pregnancy are offered. Indications for preterm delivery in the interests of the mother and fetus are defined.