[Anaesthesia in abdominal delivery in pregnant patients with hypertension].

A differentiated administration of calcium antagonists in preoperative preparation of pregnant patients with hypertension enabled the conversion of circulatory system state to "normal pregnancy range": a conversion of hypokinetic (including the HES solution infusion) and hyperkinetic types of haemodynamics to eukinetic one, with the decrease of total peripheral resistance and myocardium need for oxygen, autonomous nervous system state to physiological sympathicotonia. Evidence shows that continued intra-operative treatment including tranexamic acid enables to maintain those results during the surgery. In postoperational period, the clinical manifestations of SIRS in patients who has received the mentioned therapy were marked less then in control group, and the newborns have a higher Apgar score.

[Preoperative preparation of pregnant with hypertension according to state of the autonomic nervous system and circulatory system].

Pregnancy in patients with hypertension is considered in the spotlight of creation of general adaptation syndrome. According to evidence, when a stable hypertension in pregnant patients with hyper- and eukinetic types of haemodynamics is observed, the response of circulatory system and body fluid compartments has a moderate difference with normal. In pregnant patients with hypertension and a hypokinetic type of haemodynamics and pregnant patients with gestosis developed against the background of eukinetic type of hypertension, a physiological decrease of total peripheral resistance (TPR) is absent, which contributes into interstitial hyperhydration.

[Anesthetic service and the postoperative period in pregnant women with gestosis].

The paper analyzes the results of using in the anesthetic maintenance of pregnant females with gestosis the algorithm of preventing possible impairments in the development of the general adaptation syndrome in response to pregnancy and surgical labor. Calcium antagonists (eliminating dysfunction of secondary calcium messenger), ketonal, and tranexamic acid (which inhibiting a number of pain and inflammation mediators), and hydroxyethyl starch-130/04 solution (regenerating the endothelium) were administered to prevent the clinical manifestations of the intraabdominal compartment syndrome, ischemia-pefusion, and the second wave of the systemic inflammatory response syndrome in response to surgery. The differential use of the above agents at all stages of anesthetic maintenance in pregnant women with gestosis promoted the postoperative preservation of the most efficient eukinetic hemodynamics and physiological sympathicotonia and the elimination of water metabolic disturbances more early than in the control puerperas.

[Optimization of anesthetic service during abdominal delivery of pregnant women with gestosis].

Differential preoperative preparation of pregnant women with gestosis, by using calcium antagonists is an effective preventive measure against a circulatory hyperdynamic response to transportation to the operating suite. In pregnant women who had all hemodynamic types at baseline, the eukinetic type achieved during the preparation is retained. The patients with gestosis who did not receive calcium antagonists were found to have a circulatory hyperdynamic response with increased myocardial oxygen uptake (during surgery in particular).

[Hemodynamics, the autonomic nervous system and water metabolism as criteria for developing the general adaptation syndrome in pregnant women].

By taking into account the fact that the autonomic nervous and cardiovascular systems (ANS and CVS) are the major links of development of the general adaptation syndrome in pregnancy, which are affected by all the processes involved in the development of the syndrome, the author analyzed the state of these systems in healthy non-pregnant and pregnant women (HNPW and HPW) and in pregnant women with gestosis. HNPW were found to have already a prerequisite for impairing pregnancy adaptive processes as ANS and CVS dysfunction. In HPW, these impairments were more pronounced.