The objective of this research is to study the characteristics of parameters of central arterial pressure and indices of blood vessels rigidity in pregnant women with obstructive sleep apnоa-hypopnea. 24-hours monitoring of blood pressure and somnography tests were conducted on 43 pregnant, the average age was 28,87±5,72 years, the pregnancy – 32,43±4.25 weeks. ABPM was performed using BPLabVasotens system («PetrTelegin», Russia). The device allows to determine the propagation time of the reflected wave, augmentation index in the brachial artery (AIx) and aortic (AIxao), the parameters of the central blood pressure. Somnography was performed using portable unit Sleeptrek3 (USA). Sonographic studies of obstructive sleep apnea-hypopnoe were determined arterial hypertension in 55.8% of pregnant women, of whom 66.7% In women with obstructive sleep apnea-hypopnoe more frequent profile type "non-dipper", "night-piker", the indices of central BP and vascular stiffness were significantly higher than in pregnant women without obstructive sleep apnea-hypopnoe. The correlation between peripheral augmentation index (Alx) and indicators SBPao and DBPao was found. Pregnant women with obstructive sleep apnea-hypopnoe had the syndrome of intrauterine growth retardation in 33.3% in the comparison group at 15.8%.Conclusions. 24-hour monitoring of сentral blood pressure and indicators of blood vessels rigidity allows to detect differences of parameters in pregnant women with and without obstructive sleep apnea-hypopnoe. Pregnant with obstructive sleep apnea-hypopnoe have more risk factors for adverse pregnancy outcomes. obstructive sleep apnea-hypopnoe remains a significant predictor of intrauterine growth retardation.
hypertension in pregnancy, ambulatory blood pressure monitoring, central blood pressure monitoring, augmentation index, the propagation time of the reflected wave, obstructive sleep apnea-hypopnea.
1. Bartosh L.F., Adonina L.A., Dorogova I.V., Krylova A.V., Fateev A.V. Vozmozhnosti i klinicheskoe znachenie opredeleniya tsentral´nogo davleniya i raznitsy mezhdu tsentral´nym i perifericheskim arterial´nym davleniem u beremennykh s arterial´noy gipertenziey. Vestnik novykh meditsinskikh tekhnologiy (elektronnoe izdanie). 2012. №1. Publikatsiya 2-54. URL: http://www.medtsu.tula.ru/ VNMT/Bulletin/E2012-1/4053.pdf (data obrashcheniya: 10.07.2012).
2. Gaysin I.R. Arterial´naya gipertenziya u beremennykh - novyy kardiorenal´nyy kontinuum. Terapevticheskiy arkhiv. 2012. T. 84, №1. S. 48-53.
3. Underdiagnosis of sleep apnea syndrome in U.S. communities / Kapur V., Strohl K.P., Redline S. [et al.]. Sleep Breath. 2002. № 6(2). P. 49-54.
4. Lamberg L. Sleeping poorly while pregnant may not be «normal». J.A.M.A. 2006. №295. R. 1357.
5. Snoring, pregnancy-induced hypertension, and growth retardation of the fetus / Franklin K.A., Holmgren P.A., Jonsson F. [et al.]. Chest. 2000. №117. P. 137-141.
6. Dorogova I.V., Panina E.S. Comparison of the BPlab® sphygmomanometer for ambulatory blood pressure monitoring with mercury sphygmomanometry in pregnant women: validation study according to the British Hypertension society protocol. Vascular Health and Risk Management. 2015. №11. P. 245-249.
7. Prognostic accuracy of day versus night ambulatory blood pressure: a cohort study / Boggia J., Li Y., Thijs L. [et al.]. Lancet. 2007. №370. P. 1219-1229.
8. Hermida R.C., Ayala D.E., Mojun A., Fernandez J.R. Decreasing sleep-time blood pressure deter-mined by ambulatory monitoring reduces cardiovascular risk. Am. Coll. Cardiol. 2011. №58. P. 1165-1173.
9. Left ventricular concentric geometry as a risk factor in gestational hypertension / Novelli G.P., Valen-sise H., Vasapollo B. [et al.]. Hypertension. 2003. V. 41, №3. P. 469-475.
