Arterial hypotension and pregnancy (low blood pressure during pregnancy). Norm and pathology. The pathogenesis of complications of gestation

Hypotension during pregnancy is a dangerous phenomenon that can cause many complications. If this disease has a severe course, then the body of the expectant mother is poorly supplied with blood, which is why the fetus receives less oxygen supply than necessary. This can lead to premature birth and even miscarriage. Why do pregnant women develop hypotension?

Causes of low pressure

The reasons for this phenomenon are not fully understood. It is believed that the disease develops due to the fact that the activity of the neurohumoral apparatus, which regulates vascular tone, is disrupted.

Pathological hypotension is chronic and acute. The latter can develop due to vascular and heart failure. In pregnant women, with sudden movements or prolonged standing, fainting and collapse can be observed. Hypotonic syndrome due to acute vascular insufficiency sometimes manifests itself in the supine position. This only happens to expectant mothers. The reason for this is the syndrome of compression of the inferior vena cava. Most often, the presence of such a syndrome is detected in late pregnancy.

To date, there is no consensus on whether to consider hypotension as an independent disease or whether it is a consequence of some kind of pathology. However, it is clear that the blood circulation slows down, and the tone of the venous vessels decreases, which affects the overall tone of the body. Therefore, hypotensive patients are sensitive to changes in atmospheric pressure, they suffer from headaches, and they quickly get tired. It is clear that this complicates life even more for pregnant women than for other people. Now is the time to pay more attention to the symptoms of hypotension, which is clearly manifested during pregnancy.

Symptoms and complications

Hypotension is often detected in pregnant women at the end of the first trimester. There are cases when it proceeds without any special clinical manifestations. However, we will list all the possible symptoms that may occur in pregnant women with low blood pressure:

• lethargy;
• apathy;
• increased fatigue;
• weakness;
• reduced performance;
• feeling of lack of air;
• headache;
• sleep disturbance;
• irritability;
• dizziness;

• pain in the region of the heart;
• hypersensitivity to loud speech, noise and bright light;
• mood swings;
• nausea;
• pallor;
• thermoregulation disorder;
• periodic pain in muscles and joints;
• mood swings;
• fainting;
• varicose veins;
• rare pulse.

Some of these symptoms, such as headache, fainting, weakness, and dizziness, are especially likely to occur if a pregnant woman stays in a stuffy room for a long time, is hungry, or takes a hot bath. Perhaps the most unpleasant symptom of hypotension is orthostatic hypotension. It manifests itself in the event that you abruptly get up from a sitting or horizontal position. In this case, there is a darkening in the eyes, a feeling of cottoniness in the legs and loss of consciousness. In addition, if hypotension occurs during pregnancy, complications may occur. These include:

• preterm pregnancy;
• preeclampsia;
• early toxicosis;
• intrauterine growth retardation of the baby;
• anomalies of labor activity;
• premature birth.

In this regard, it is very important to diagnose the disease in time and start treating it.

Treatment of the disease

Hypotension in pregnant women should be treated under the supervision of a cardiologist. Basically, pregnant women need to carefully monitor their lifestyle.

1. Nutrition. Nutrition should be based on a large intake of protein foods. Large meals should be avoided. It is best to use a fractional system: 4-6 times a day in small portions. In the afternoon and in the morning, pregnant women are advised to drink strong tea, preferably green, and coffee.
2. Complete rest. It is best to sleep 10 hours at night and a couple of hours during the day.
3. Walks in the open air.
4. Special gymnastics, which may include classes in the pool.

Pregnant women should not get involved in medicinal herbs and medicines. This can cause serious complications, especially since many of them should not be consumed in such a special position. You should not try any methods of treatment on your own. You should always consult a doctor.

If a pregnant woman faints, the following steps should be taken:

1. put it so that the head is on the same level with the heart, preferably in a cool room;
2. let her inhale ammonia (therefore, pregnant women are advised to carry it with them);
3. then you can give the pregnant woman a tonic (therefore, it is best to call an ambulance), herbal tonics: eleutherococcus, hawthorn, ginseng, lemongrass, and so on;
4. drink a woman sweet tea with lemon.

Pregnancy is a very responsible and sensitive period. All actions, one way or another, affect both the health of the baby and the health of his mother. This should encourage you to make every effort so that all 9 months of carrying the baby pass safely, then he will be born healthy and happy!

Blood pressure for pregnant women is measured without fail at each scheduled visit to the antenatal clinic. The doctor, as a rule, pays more attention to the fact of its increase. But often experts do not pay attention to hypotension in pregnant women (that is, low blood pressure).

This is due to the fact that it does not cause any particular inconvenience to the expectant mother, unlike hypertension, and it is usually associated with hormonal changes that occur against the background of the development and course of pregnancy, heredity, the characteristics of the woman's body, her physical activity and nutrition.

And yet, it happens that a sharp decrease in blood pressure leads to exorbitant weakness of the whole organism and a deterioration in well-being so that the expectant mother is not able to lead an active lifestyle, which is required for her position. In addition, it can lead to disturbances in metabolic processes, which will also negatively affect pregnancy.

Norm and indicators of hypotension in pregnant women

Hypotension is the term for low blood pressure. To determine this condition, the measurement is carried out on both hands, and the indicator must be below the norm by 10% or more.

The assessment of the pressure of a pregnant woman is carried out on the basis of her so-called "working" pressure before pregnancy, and the average statistical age standard is not taken into account in this case. This means that in the case when the "working" pressure in a woman was kept between 100/70 and 110/80 mm. rt. Art., and at the same time she felt good and cheerful and her working capacity was at a high level, then these same limits are taken as the norm when pregnancy occurs in this individual case.

The average blood pressure during pregnancy is between 100/70 and 150/80 mm. rt. Art. These figures are usually typical for the first two trimesters of this period. Closer to childbirth, when the body weight of the expectant mother, the fetus increases, and at the same time the volume of circulating blood, blood pressure should increase slightly. This is fine. The allowable increase in this case is 15-20 units of systolic pressure and 10-15 units of diastolic pressure. Any excess (or vice versa) of these figures is considered a deviation and is subject to therapeutic correction when making a diagnosis - hypotension or hypertension.

Causes of hypotension in a pregnant woman

A tendency to hypotension during pregnancy is observed and noted, as a rule, in women with reduced body weight and a fragile physique.

The reasons for this condition may be:

• Hormonal changes in the body.
• Chronic diseases of the stomach and the whole digestive tract.
• Allergic reactions (reduced immunity).
• Thyroid dysfunction.
• Functional disorders of the adrenal glands.

Signs in which there is a suspicion of hypotension during pregnancy

Hypotension as a pathology in a woman carrying a child is diagnosed when her blood pressure, when measured, shows figures below the norm, that is, does not reach 100/60 mm. rt. Art.

Suspicion of this type of disease may arise if the condition of the expectant mother is expressed by the following signs:

• Attacks of shortness of breath are noted with slight acceleration during walking, light physical exertion, or even at rest (usually in late pregnancy).
• There are frequent dizziness, sometimes fainting, especially in the morning, while getting out of bed.
• Rapid fatigue is noted, even with low physical exertion, or while walking in the fresh air.
• The feeling of constant lack of sleep, that is, the state of drowsiness accompanies a woman constantly.
• The woman complains of paroxysmal intense weakness.

All these signs, suggesting suspicions of hypotension, as a rule, make themselves felt in the morning, immediately after waking up.

It happens that it is precisely because of a sharp drop in blood pressure and even fainting in the first weeks after the onset of pregnancy that a woman begins to suspect her new status as a “future mother”.

When hypotension begins at the very beginning of pregnancy and blood pressure indicators fluctuate within acceptable physiological norms, doctors do not classify this as a pathology.

Usually, this process of pressure reduction is caused by the mechanism of functional restructuring of many organs and systems of a woman. All these changes in their work are directly related and their purpose is to provide a protective function and healthy conditions for the development and growth of an infant in the womb: the optimal amount of such an important substance as oxygen and various nutrients entering the child's body.

The early periods of the gestation period are distinguished by such a process as the expansion of small vessels that contain a large volume of venous and arterial blood, in order to fully saturate all mother's organs and tissues with oxygen, especially in the small pelvis and uterus.

Actually, this is precisely what becomes the main reason for the development of the hypotonic state of a pregnant woman.

Hormonal effect on blood pressure

The corpus luteum, which is formed after the release of the egg, forms the pregnancy hormone - progesterone. In turn, it creates favorable conditions directly inside the fallopian tube so that the embryo reaches the uterine cavity without hindrance and can strengthen itself there.

How are these conditions created? Progesterone has a relaxing effect on the smooth muscles of the uterus and tubes. This is necessary, because if the muscles of these organs are in a state of tone, the embryo cannot move along them and attach to the wall. And that means he is in for an imminent death.

As a result of this effect of progesterone, the walls of small vessels also relax, which contributes to their expansion, and, accordingly, a decrease in blood pressure.

With the course of the pregnancy itself, as well as fetal development and growth, hypotension disappears. This happens already by the beginning of the second trimester of pregnancy.

If this does not happen, then the doctor defines the hypotonic state as pathological, capable of harming the well-being of the expectant mother and the development of her fetus, and therefore subject to therapeutic correction.

Clinical picture of hypotension in pregnancy

Low blood pressure forces the heart muscle to work more actively, speeding up the heart rate. At the same time, the brain begins to receive less oxygen, which manifests itself through the following clinical picture:

• Constant drowsiness;
• Night sleeplessness;
• Shortness of breath even with little physical exertion;
• Fainting even from the slightest lack of fresh air;
• Low level of performance;
• High level of irritability, tearfulness, emotional sensitivity;
• Low level of concentration;
• weather sensitivity;
• Tinnitus.

The danger of hypotension to the fetus

It is very important to know that hypotension in pregnant women can cause quite serious harm to fetal development, since blood circulation worsens not only in the mother, but also in the placenta, and the child ceases to receive enough nutrition and oxygen for normal development and growth.

Insufficient blood supply, in turn, causes placental insufficiency, fetal preeclampsia, and the threat of normal delivery.

In addition, the mother’s low blood pressure during pregnancy can also have a negative impact after childbirth: the recovery period will be longer and less intense, since the body will not have enough strength for the stress that will inevitably arise in the process of caring for the baby.

Significantly low blood pressure in pregnant women can be very dangerous and cause complications that threaten various pathologies and unhealthy conditions of the fetus.

First of all, hypotension can cause. The very first to suffer are the kidneys, heart and vessels of the brain of the head, and not only the mother's body, but also the baby.

As a rule, hypotension is replaced by hypertension, which is very difficult to stop during pregnancy. Moreover, hypertension causes convulsions and cerebral edema due to impaired blood circulation.

The chronic form of hypotension can cause an exacerbation of chronic infectious diseases (if any in a woman's history), a decrease in immunity, and therefore pregnancy becomes more difficult.

With hypotension in a pregnant woman, labor can be complicated. This complication will be caused by violations of the contractile function of the uterus, due to impaired blood flow and, accordingly, low blood pressure. Often such childbirth is accompanied by heavy bleeding.

Therapy of hypotension in pregnancy

There are several options used to treat hypotension. The special position of a woman, that is, pregnancy in this regard, is no exception. On the contrary, when choosing therapeutic measures in such cases, the doctor examines the patient's condition more carefully and, accordingly, selects methods of treatment and means more carefully. For each specific period of pregnancy and case, therapy is purely individual.

Pathological hypotension, as the disease is also called, with the threat of termination of pregnancy, suggests a stationary regimen. The expectant mother is placed in a specially designed medical facility or hospital department under the close attention of doctors.

Treatment of crises involves the use (subcutaneously) of a 5% solution of ephedrine with a dosage of 0.5 ml. Caffeine is also injected intramuscularly, more precisely 10% of its solution at a dose of 1.0 ml.

With further medical treatment, preference is still given to pharmaceuticals of plant origin. In this regard, extracts or tinctures are used, in particular, an extract of radiola rosea, eleutherococcus, tincture of Schisandra chinensis, zamaniha, aralia, and other plants corresponding to this group of plants.

As a rule, in combination with drugs of the previous group, which have an active effect on the ANS, sedative drugs are prescribed. They are also of vegetable origin. Traditionally, it is recommended to take decoctions of motherwort or valerian.

Pharmacological drugs are also prescribed that affect the properties of the blood, in particular rheological, for example, dipyridamole, as well as acetylsalicylic acid in small doses. Caffeine is recommended for headaches. It is taken per day 2 - 3 times in the amount of 0.05 - 0.1 g (one time).

With a sharp decrease in pressure, fainting occurs. In such a situation, the pregnant woman is allowed to smell ammonia, and when she regains consciousness, some kind of tonic, for example, 35-40 drops of cordiamine.

Physiotherapy is also of great importance in the treatment of hypotension. Acupuncture, coniferous extracts for the bathroom, bathing in mineral baths, sea bathing, electrosleep, all this has a beneficial effect on the body of the expectant mother.

With a degree of hypotension that allows improvement of the condition at home, the pregnant woman is also under medical control, but remotely. Here, mommy herself must unquestioningly follow all the recommendations of the doctor, and not her friends, and clearly adhere to a strict regimen. Moreover, a strict regime provides not only a daily routine, but also nutrition, an emotional state.

Prolonged sleep is highly recommended, approximately 10 hours at night and approximately 2 hours of rest during the day. After waking up, it is better to lie down for a few minutes (5 - 7), and then just get up, moreover, slowly. Getting up suddenly can cause nausea and dizziness. A few hours should also be spent outdoors. Special gymnastics and a contrast shower, as far as possible, are also recommended to be included in the daily routine.

The nutrition of a pregnant woman should be varied mineral and vitamin saturated. If the craving for salt increases, as a rule, it is cabbage or cucumbers, then these products at reduced pressure, if there are no other contraindications, can not be limited. Fasting is unacceptable with hypotension. Broth soups and broths are recommended. It is desirable to introduce a vegetable such as celery into the diet. It is not only able to increase blood pressure, but also has a beneficial effect on hemoglobin levels.

Expectant mothers, whose favorite drink was coffee before pregnancy, are advised to switch to chicory. Natural coffee, but not instant, you can drink only in the form of latte or cappuccino, and then very rarely.

For a healthy young woman, normal blood pressure numbers are: systolic blood pressure 100-120 mm Hg. Art., and diastolic blood pressure 5-80 mm Hg. Art. During pregnancy, many women tend to lower blood pressure below t00 and 60 mm Hg. Art. The reasons for this are changes in the work of the endocrine and nervous systems, which leads to the expansion of blood vessels and a change in the intensity of metabolism.

Tall thin women with pale skin, varicose veins and cold hands are more susceptible to arterial hypotension.

Some pregnant women tolerate arterial hypotension well, other women feel weakness, fatigue, malaise, dizziness, heart palpitations, nausea, sometimes fainting is possible. Unpleasant sensations accompany this condition more often in the first half of pregnancy, at a later date the body adapts to a new level of blood pressure, and the woman's well-being is not disturbed.

With good health, the help of a pregnant woman is not required. In case of malaise, dizziness, loss of consciousness, it is necessary to lay the woman down, slightly raise her legs, give her a sniff of ammonia (in case of loss of consciousness), offer to drink strong tea with sugar or a little coffee. With a pronounced drop in blood pressure, drugs are used that stimulate cardiac activity and somewhat narrow arterial vessels (caffeine, cordiamine).

If hypotension, arterial hypotension, is observed among the entire population in 5-7%, then among pregnant women twice as often - in 10-12%. This is a disease in which there is a decrease in blood pressure (blood pressure) to 100/60 and below. With physiological hypotension, a person does not respond to reduced pressure, pregnant women remain in good health, they do not complain.

Employability is preserved.

But arterial hypotension can manifest itself for the first time only during pregnancy.

It is believed that the main factor contributing to the development of arterial hypotension in pregnant women is the emergence of an additional uteroplacental circulatory system. The chorion and then the placenta produce hormones that suppress the pituitary gland of the pregnant woman, the release of vasopressin, which increases vascular tone, stops, and a decrease in blood pressure is formed.

Primary and symptomatic hypotension is distinguished. Primary hypotension is a typical neurogenic disorder of vascular tone. A neurosis that disrupts the tone of blood vessels is formed in young women who are not ready to realize the fact of their pregnancy, those for whom pregnancy is a shock. We will talk about neurogenic and psychogenic disorders in pregnant women separately, in a special section.

There are three stages of arterial hypotension: stage I - stable, compensated hypotension, manifested only by a decrease in blood pressure; Stage II - unstable, subcompensated hypotension, manifested by a variety of subjective and objective symptoms; Stage III - decompensated hypotension, characterized by insomnia, dizziness, fainting, hypotensive crises, cold ears and nose, hands and feet, disability is lost.

The picture of hypotension is very diverse, numerous complaints from the whole organism and individual organs. This is lethargy and apathy, weakness and fatigue in the morning, memory loss, headache, dizziness, stabbing in the heart, palpitations. Irritability, bad mood. Orthostatic phenomena are characteristic - a critical decrease in pressure, with a change in body position, especially when standing up, there is a darkening in the eyes, noise in the ears and their congestion, fainting against the background of relatively good health. The pulse is weak, variable, often slow. When listening, there is a murmur during the contraction of the heart. But there are no abnormalities on the ECG.

Hypotonic crises occur when the blood pressure is critical - 80/40 to 75/30 mm Hg. Art., headache and dizziness intensify, lay the ears, skin and mucous membranes turn pale, hands and feet are cold to the touch, cold sweat appears.

Pregnant women with hypotension are often asthenic, lean, intersex (not feminine and not masculine), in 17% of cases hypotension is combined with low hemoglobin - anemia.

In 85% of pregnant women with hypotension, early toxicosis is observed, when nausea and vomiting, intolerance to odors join the symptoms. In 25% in the second half of pregnancy, preeclampsia occurs, which is complicated by placental insufficiency, hypoxia, and IUGR of the fetus - in 35%. The threat of miscarriage or premature birth is 3-5 times more likely with hypotension than in healthy pregnant women. With preeclampsia, the rise in blood pressure to 120/80 mm Hg. Art. for hypotonic pregnant women, it is almost critical, since it is 30% higher than the initial one.

During childbirth, weakness of labor is often manifested, but this is not a true weakness, but a delayed type of development of labor, associated with a significant depletion of the body's energy resources, with a slowdown in metabolism, characteristic of hypotension. If they begin rhodostimulation, then discoordination of labor activity develops, in which different parts of the uterus contract in different rhythms, so there is a threat of uterine rupture. Rhodostimulation should be stopped, the woman should be provided with drug-induced sleep.

After the birth of a child, hypotonic bleeding may occur, to which a hypotensive mother reacts very strongly, shock can develop very quickly, and careful restoration of blood loss is required.

Treatment of hypotension during pregnancy

Treatment of the compensated form is not required. Treatment of de-compensated forms of hypotension begins with the regulation of work and rest. Night sleep is required for at least 8 hours and daytime rest-sleep for 2-3 hours. An effective remedy is physiotherapy exercises, morning exercises are very important. Then tonic water procedures should be prescribed - a contrast shower, Charcot's shower. 4 meals a day are prescribed, with tea and coffee (but not at night).

Physiotherapy - UVI, electrophoresis with calcium on the collar zone. Therapeutic massage and electrosleep are also used.

Vitamins, biostimulants are prescribed - Chinese magnolia vine, aralia, lure, eleutherococcus, ginseng. Herbal medicine is selected individually.

If necessary, agents that improve the nutrition of the heart are used, for example, riboxin, panangin, vitamin C and B vitamins.

In hypotensive crises, drugs like adrenaline are used in microdoses so as not to cause excessive vasospasm. Childbirth is carried out through the natural birth canal.

Pregnancy- this is a state in which all the forces of the body are mobilized in order to provide the best possible conditions for the development of a new life. Of course, we can say with good reason that pregnancy is a stressful state for a woman. It's not a secret for anyone that during pregnancy all the ailments experienced by the expectant mother can “come to light”, even if they went unnoticed before conception. It concerns and arterial hypotension (hypertension).

During pregnancy arterial pressure women often go down a little. Therefore, the usual slightly low pressure, which does not in the least interfere with the normal life of a woman, can turn into a sharp and strong decrease in it, which entails a wide variety of problems. In severe cases, with hypotension, the body of a pregnant woman is worse supplied with blood, and the child receives less oxygen. This may pose a risk miscarriage or premature birth. Therefore, women who had hypotension before pregnancy should especially carefully monitor their pressure and, if it drops sharply, immediately contact doctor .

However, more often, the hypotension of a pregnant woman does not cause serious problems on the part of the fetus, but greatly complicates the life of the expectant mother. If a pregnant woman stands for a long time, is in a stuffy room, takes a hot bath, or is simply hungry, then hypotension may occur. weakness, dizziness, headache, even fainting. In addition, abrupt mood swings in pregnant women are often associated with hypotension - from euphoria and love for the whole world to tears, fear and a feeling of helplessness and uselessness. It should be borne in mind that during pregnancy, such mood swings are more or less characteristic of everyone, but in pregnant women with hypotension, they can be especially pronounced. Therefore, pregnant women with a tendency to hypotension should take all measures to avoid such conditions.

For pregnant women with hypotension, all those drugs that are commonly used to increase blood pressure .

Nutrition should be varied, with a high content of protein foods. Abundant nutrition should be avoided, it is harmful not only for pressure, but also in terms of pregnancy, especially in the later stages. It is best to stick to the fractional nutrition system, that is, eat at least 4-6 times a day, but in small quantities. In the morning and afternoon, pregnant women with hypotension benefit from strong tea, especially green tea, and coffee.

It is very important for expectant mothers, as for all hypotensive patients, to have a good rest - at least 10 hours of sleep at night and 1-2 hours of rest during the day. Indispensable daily walks in the fresh air, special gymnastics, classes in the pool. Water procedures are generally exceptionally useful for pregnant women with hypotension. They can be recommended and a cool shower, and cold douche (necessarily with the head) or contrast baths for arms or legs.

The only thing you should not get involved in pregnant is treatment of hypotension with the help of medicines or medicinal herbs, since many of them are contraindicated during pregnancy. Therefore, before using any drugs, you should definitely consult with pregnancy doctor, or at cardiologist. If the remedy that the woman used before pregnancy is contraindicated for her, the doctor will prescribe another one with a similar effect.

If, nevertheless, an attack of poor health occurs or fainting associated with a sharp decrease in pressure, it is necessary to provide first aid to a pregnant woman. First of all, you need to lay it (preferably in a cool room) so that the head is on the same level with heart. If you lose consciousness, you can give ammonia to inhale. After the woman has come to her senses, it is useful for her to take 35-40 drops cordiamine or similar tonic, eat a little and drink a glass of strong sweet tea with lemon.

With hypotension, a pregnant woman should pay close attention to all examinations, especially to fetal ultrasound, which is carried out several times during pregnancy. This is very important because hypotension during pregnancy can cause problems such as fetal hypotrophy appearing in late pregnancy. This happens due to the fact that with severe hypotension, blood supply worsens. uterus, placenta and fetus. In this case, the unborn child receives insufficient nutrition and oxygen, which can lead to a state of oxygen starvation and a slowdown in fetal growth. Hypotension of a pregnant woman during operative delivery can have dangerous consequences, that is, with caesarean section. Usually in these cases, hypotension is prevented by medication before surgery.

A woman who is going to give birth to a healthy child must take into account the characteristics of her body even before conception. Hypotension can in no way be a contraindication for pregnancy and successful delivery, especially if the expectant mother undergoes the necessary examinations even before the onset of pregnancy. She needs to visit consultation with a cardiologist and a physiotherapist, observe the daily routine, eat right, give yourself moderate exercise, etc. When a pregnant woman with hypotension takes care of her general health and pressure in particular, the probability of a successful pregnancy and the birth of a healthy child is very high.

Hypotension and pregnancy

Low blood pressure in pregnant women is a fairly common phenomenon, it is observed in almost a third of patients. Most often, hypotension manifests itself at the end of the first trimester, it is diagnosed somewhat less often at 17–24 weeks of pregnancy.

Arterial hypotension during pregnancy is dangerous, in particular because in some cases it occurs without pronounced clinical manifestations. Therefore, regular monitoring of blood pressure is of great importance.

Fluctuations in blood pressure within 10% of normal are considered acceptable, if the pressure has decreased by a greater value, you should consult a doctor.

The reasons for the development of hypotension during pregnancy, experts include:

- a sharp change in hormonal levels;

- the formation of the uteroplacental bed, which is an additional blood depot;

- increased tone of the parasympathetic division of the autonomic nervous system;

– change in the higher autonomic centers of vasomotor regulation;

– decrease in total peripheral vascular resistance;

- inhibition of all functions that prevail over excitation.

Most women mistake the symptoms of low blood pressure for natural manifestations of pregnancy. Nausea, constant weakness, drowsiness, fatigue cause serious discomfort, but often do not cause concern.

Meanwhile, the listed symptoms are characteristic of arterial hypotension, their presence is a reason to consult a doctor. Even sudden mood swings - from a state close to euphoria to depression, are usually a consequence of hypotension.

The researchers argue that for women with low blood pressure, they are more characteristic than for pregnant women, whose pressure corresponds to the average norm.

Hypotension during pregnancy can lead to dizziness, nausea, and fainting. Such consequences are most often manifested with a long stay in an upright position, lack of oxygen (for example, if a pregnant woman finds herself in a poorly ventilated room or public transport during rush hour), after taking a hot bath or shower, if the diet is not followed.

Any of these conditions should cause alertness. We should not forget that arterial hypotension not only reduces the well-being of a pregnant woman, but also often poses a serious threat to the normal development of the fetus.

Arterial hypotension occurs in 10-12% of pregnant women, which is about twice the average for the population as a whole.

Hypotension can cause a number of serious complications during pregnancy. These include:

- early toxicosis (occurs in the first trimester of pregnancy, which is an extremely important period for the formation of the body of the unborn child. There are several reasons for the development of early toxicosis, and hypotension only enhances its manifestations. Toxicosis is often accompanied by repeated severe vomiting, leading to dehydration of the body, and this, in turn, leads to a decrease in blood pressure. This vicious circle can only be interrupted with the help of specialists, since hospital treatment is often required);

- fetal malnutrition (manifested, as a rule, in late pregnancy and is associated with a deterioration in the blood supply to the uterus, placenta and fetus. As a result, the fetus receives an insufficient amount of nutrients and oxygen, which often leads to oxygen starvation and a slowdown in development);

- threatening spontaneous miscarriage (a common pathology of pregnancy for up to 20 weeks, can be caused by a number of reasons, including arterial hypotension);

- fetoplacental insufficiency (impaired formation and functions of the placenta, which develops, among other things, due to a lack of blood supply caused by low blood pressure. FPI causes fetal hypoxia, can lead to the formation of congenital malformations, spontaneous abortion, premature birth);

- preeclampsia (a pathology of pregnancy that develops in its later stages and manifests itself in a deterioration in the functioning of the kidneys, blood vessels and brain of pregnant women. Preeclampsia not only worsens the well-being of the expectant mother, but also negatively affects the development of the fetus, inhibiting it. One of the symptoms of preeclampsia is a sharp increase in blood pressure, which can go unnoticed against the background of hypotension. Indeed, at a pressure of 90/60 mm Hg. may not cause concern, because the latter is the norm for the majority);

- premature birth (the birth of a child at the 28-37th week of gestation. There are many reasons for premature birth, as one of them experts recognize low blood pressure during pregnancy).

table 2

The most common complications of arterial hypotension during pregnancy

Unfortunately, these complications are far from uncommon in women with low blood pressure. (Table 2) therefore, they are shown regular monitoring by specialists throughout the entire period of pregnancy.

It should also be mentioned that the usual methods of treating hypotension, both medical and non-traditional, are often not applicable during pregnancy, so a doctor's consultation is necessary in each case.