Cardiovascular consequences of great obstetrical syndromes

Akhmadeev N.R., Fatkullin I.F., Fatkullina L.S.

1) Kazan State Medical University, Ministry of Health of the Russian Federation, Kazan, Russia; 2) City Clinical Hospital No. 16, Kazan, Russia
The great obstetrical syndromes (GOS) are a term that summarizes major obstetric complications from a pathogenesis perspective. It includes preterm labor, pre-labor rupture of membranes, pre-eclampsia, fetus small for gestational age (low birth weight), and other conditions. The pathogenesis of GOS includes immune and vascular elements, which, among others, determine its effects on the cardiovascular system. Preeclampsia is the most studied complication of pregnancy in terms of the development of cardiovascular complications, including arterial hypertension, impaired cardiac function, risk of cardiovascular events, and mortality. Fetal growth restriction and preterm birth are not accompanied by the development of critical organ dysfunction; however, the common pathogenesis determines the risk of future cardiovascular events. The cardiovascular risk in patients with obstetric complications is elevated even before pregnancy; therefore, the development of GOS may trigger the development of complications. Despite the existence of some evidence base on the consequences of GOS, patient follow-up is not organized, and a regulatory framework has not been developed. The Russian Federation has no regulatory framework for the inclusion of such patients in outpatient medical supervision. Early diagnosis and appropriate rehabilitation can minimize the risk of long-term sequelae.
Conclusion: The data presented in this review indicate a high incidence of cardiovascular events following obstetric complications. The development of a methodology, forms of implementation, and recommendations for rehabilitation based on interdisciplinary interaction and continuity can become a new direction for scientific research and organizational solutions to this important problem.

Authors' contributions: Fatkullin I.F. – author of the idea, analysis of the state of the problem; Akhmadeev N.R. – data collection, systematization, data analysis, manuscript drafting; Fatkullina L.S. – author of the idea and its development.
Conflicts of interest: The authors have no conflicts of interest to declare.
Funding: There was no funding for this study.

For citation: Akhmadeev N.R., Fatkullin I.F., Fatkullina L.S. Cardiovascular consequences of great obstetrical syndromes.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (4): 5-11 (in Russian)
https://dx.doi.org/10.18565/aig.2022.287

Keywords

great obstetrical syndromes
cardiovascular disease
mortality
GOS
pre-eclampsia
preterm delivery
fetal growth restriction

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Received 30.11.2022

Accepted 24.03.2023

About the Authors

Nariman R. Akhmadeyev, Ph.D., Associate Professor, Department of Obstetrics and Gynecology named after Prof. V.S. Gruzdev, Kazan State Medical University, Ministry of Health of Russian Federation; Head of Labor Department No.1, City Clinical Hospital No.16, Kazan, +7(919)690-39-57, akhmadeyevnr@gmail.com, https://orcid.org/0000-0003-0908-7256, 420012, Russian Federation, Kazan, Butlerova str., 49.
Ildar F. Fatkullin, Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology named after Prof. V.S. Gruzdev, Kazan State Medical University, Ministry of Health of Russian Federation, +7(960)048-01-04, fatkullin@yandex.ru, https://orcid.org/0000-0001-9673-9077, 420012, Russian Federation, Kazan, Butlerova str., 49.
Larisa S. Fatkullina, Ph.D., Associate Professor, Department of Obstetrics and Gynecology named after Prof. V.S. Gruzdev, Kazan State Medical University, Ministry of Health of Russian Federation; Chief Freelance Specialist in Obstetrics and Gynecology of Kazan Department of Health of Ministry of Health of the Republic of Tatarstan, +7(953)405-67-47, fatkullinalara@gmail.com, https://orcid.org/0000-0003-0361-2785, 420012, Russian Federation, Kazan, Butlerova str., 49.

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