Scientific rationale for personalized selection of antihypertensive therapy and management tactics for pregnant women with hypertensive disorders
Objective. To develop and justify a personalized system for selecting an antihypertensive therapy regimen and management tactics for pregnant women with different types of hypertensive disorders.Panova I.A., Rokotyanskaya E.A., Malyshkina A.I., Kudryashova A.V.
Subjects and methods. The investigators assessed the elastic properties and autonomic regulation of blood vessels and determined the blood content of leukocytes expressing CD62L, CD11b, CD49b, CD99, CCR2, CCR5, CX3CR1, CXCR1, and CXCR2, and the serum levels of MCP-1, RANTES, Fractalkine, and IL-8 in 147 pregnant women with chronic hypertension (CH), 109 with CH and secondary preeclampsia (PE), and 201 with PE.
Results. Based on clinical, laboratory, and functional examination data, the authors developed mathematical models including criteria for selecting an antihypertensive therapy regimen for pregnant women with different types of hypertensive disorders, for predicting the efficiency of therapy for moderate PE, and for choosing management tactics for severe early PE.
Conclusion. The proposed system will be able to optimize the management of pregnant women with different hypertensive disorders.
Keywords
pregnancy
hypertension
preeclampsia
antihypertensive therapy
management tactics
mathematical model
References
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Received 25.04.2019
Accepted 21.06.2019
About the Authors
Irina A. Panova, doctor of medical sciences MD, assistant professor, head of Department of obstetrics and gynecology, Federal State Budget Establishment«Ivanovo Research Institute of Maternity and Childhood named V.N. Gorodkova» of the Ministry of Health of Russia.
Phone: +7(4932)35-18-62. E-mail:ia_panova@mail.ru; ORCID 0000-0002-0828-6547
153045, Russia, Ivanovo, Pobedy str. 20.
Elena A. Rokotyanskaya, candidate of medical Sciences PhD, assistant Professor of the Department of Obstetrics and Gynecology, Neonatology, Anesthesiology and Reanimatology, Federal State Budget Establishment «Ivanovo Research Institute of Maternity and Childhood named V.N. Gorodkova» of the Ministry of Health of Russia. Phone: +7 (4932)35-18-62. E-mail: rokotyanskaya.ea@mail.ru, ORCID 0000-0003-4660-7249
153045, Russia, Ivanovo, Pobedy str. 20.
Anna I. Malyishkina, doctor of medical sciences MD, Director, Federal State Budget Establishment «“Ivanovo Research Institute of Maternity and
Childhood named V.N. Gorodkova» of the Ministry of Health of Russia. Phone: +7 (4932)33-83-20, E-mail: ivniimid@inbox.ru, ORCID 0000-0002-1145-0563
153045, Russia, Ivanovo, Pobedy str. 20.
Anna V. Kudryashova, doctor of biological sciences BD, senior researcher of the laboratory of clinical immunology, Federal State Budget Establishment «Ivanovo Research Institute of Maternity and Childhood named V.N. Gorodkova» of the Ministry of Health of Russia.
Phone: +7 (4932)33-69-28. E-mail:niimid.immune@mail.ru; ORCID 0000-0002-8501-1029 153045, Russia, Ivanovo, Pobedy str. 20.
For citation: Panova I.A., Rokotyanskaya E.A., Malyshkina A.I., Kudryashova A.V. Scientific rationale for personalized selection of antihypertensive therapy and management tactics for pregnant women with hypertensive disorders.
Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2020; 1: 110-8. (In Russian).
https://dx.doi.org/10.18565/aig.2020.1.110-118