PERINATOLOGY AND PEDIATRIC. UKRAINE. 2017.3(71):32-38; doi 10.15574/PP.2017.71.32

Grishchenko O. V., Lakhno I. V., Demchenko O. B., Storchak A. V., Bobritskaya V. V., Dudko V. L.
Kharkiv Medical Academy of Postgraduate Education, Ukraine

Preeclampsia is one of the most important problems of modern obstetrics. Preeclampsia complicates from 5.0% to 16.0% of pregnancies, 5 times increases the risk of perinatal losses and accounts more than 50 000 cases of maternal deaths in the world annually.
Objective — to investigate the state of maternal and fetal autonomic nervous regulation in healthy pregnancy and in preeclampsia.
Material and methods. 292 pregnant women were examined, 154 of them were preeclamptic. The variables of sympathovagal balance, central maternal hemodynamics and spectral analysis of the blood flow velocity curves in the cord vein were studied.
Results. Preeclampsia develops on a background of sympathetic overactivity, a suppression of total autonomic tone and parasympathetic branch of regulation. This helps to provide a hyperkinetic type of central maternal hemodynamics, which compensatory supports a sufficient level of perfusion of end-organs in women with mild and moderate preeclampsia. The lack of vagal tone, the further decrease in autonomic nervous regulation coupled with the peripheral vascular resistance increase and cardiac index decrease play the important roles in the development of hypokinetic type of central maternal hemodynamics in patients with severe preeclampsia. The latter leads to the dissociation of maternal and fetal regulatory mechanisms.
Conclusions. Hemodynamic isolation of the fetus leads to its sympathetic overactivity, a decrease in the total level of autonomic nervous regulation, centralization of hemodynamics and fetal distress.
Key words: preeclampsia, autonomic nervous regulation, hemodynamics, umbilical vein, vagal repercussions theory.

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