RATIONAL CONTROL OF ARTERIAL PRESSURE DURING LABOUR IN WOMEN WITH ARTERIAL HYPERTENSION

Arterial hypertension can significantly impair the health of the pregnant woman and often causes complications in childbirth and perinatal complications.The purpose of the study: to identify the advantages and disadvantages of various antihypertensive regimens in women with hypertension during the labor process and their effect on the course of labor and perinatal outcomes.Materials and methods: There were surveyed for the period of 2013-2018 years 228 women who had labour in the Ternopil perinatal center “Mother and Child”. Arterial hypertension was verified in 172 women, 56 women were healthy and formed a control group. The study included delivery time of 40 ± 2 weeks of gestation. According to the treatment program, the women in labour were divided into 4 groups: the first group - 58 women who neglected the treatment of chronic arterial hypertension before pregnancy, and during pregnancy there was insufficient compliance; The second group - 57 women in labour with AH, which were used dopegit and classic beta-blockers, (metoprolol, bisoprolol) during pregnancy; The third group - 57 women in labour who received high selective beta-blocker with vasodilating effect nebivolol for treatment of hypertension; The fourth group - 56 healthy women in labour without hypertension and / or other somatic pathology.Results of the research and their discussion. The recommended program of treatment for hypertension (with nebivolol hydrochloride) proves the sufficient control of blood pressure and avoiding of high blood pressure spikes or excessive increase of SBP, DBP, and heart rate during childbirth, which could endanger the mother’s health.Conclusions. The therapy with nebivolol hydrochloride for laboring women with chronic arterial hypertension allows to normalize the course and duration of childbirth, to reduce the percentage of such complications as a prolonged labour or unsatisfactory progress of labour, and to reduce the level of blood loss during child-birth