Rogova E F, Tareeva I E, Sidorova I S, Makarov I O, Rogov V A, Zozulia O V
Ter Arkh. 2001;73(10):28-33.
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.
研究妊娠合并原发性高血压（EH）孕妇的肾脏和子宫血流动力学的孕期变化，及其与全身和心内血流动力学的关系。
对48例1 - 2级EH孕妇及20例健康对照孕妇在妊娠中晚期及产后3个月进行超声心动图、肾动脉和子宫动脉超声多普勒检查以及翻身试验。将孕期血流动力学参数与产后参数进行比较，后者被视为基础值。
EH孕妇和对照孕妇的全身和心内血流动力学变化在许多方面相似，但EH孕妇的收缩压变化不显著，每分输出量因心率增加而升高。二级EH孕妇在妊娠晚期翻身试验阳性更为频繁，这表明血管系统的升压反应性较高。EH孕妇在肾动脉阻力不变的情况下血流速度较高。随着妊娠时间的增加，子宫动脉阻力下降。无论总外周血管阻力（TPVR）如何，在心脏收缩增强时肾动脉主干阻力升高。在动脉压升高、TPVR升高、心率降低和心脏收缩功能降低时，子宫动脉血流恶化。肾脏和子宫血流动力学相互独立。
对照孕妇和EH孕妇的血流动力学变化在许多方面相似，但较高的动脉压、左心室收缩功能异常、心动过缓会干扰子宫血流。肾循环独立于全身和心内血流动力学，且与子宫循环变化无关。
