Arterial hypertension in pregnant women: «comorbidity» or a risk factor for postoperative infectious complications?


N.A. Korobkov, N.V. Bakulina, M.V. Maximov

1) North-Western State Medical University n.a. I.I. Mechnikov, St. Petersburg, Russia; 2) First St. Petersburg State Medical University n.a. Academician I.P. Pavlov, St. Petersburg, Russia
Background. The risk of infectious complications after caesarean section in patients with arterial hypertension has not been studied enough.
Objective. to do research on the causal link between hypertensive disorders during pregnancy and the development of endometritis after caesarean section; to determine the prognostic value of arterial hypertension as an independent predictor of the development of postoperative infectious and inflammatory complications.
Methods. A retrospective study analysis of case histories and data from medical source records of 406 puerperas with endometritis after caesarean section and 242 puerperas with an uncomplicated postoperative period is completed.
Results. The frequency of hypertensive disorders during pregnancy is quite evident. The level of postpartum infectious morbidity wasn’t higher in puerperas with pregnancy-induced arterial hypertension (preeclampsia, gestational hypertension). As known, preeclampsia can develop faster in women having antenatal infection in past medical history, however, the inverse assumption about a higher number of postpartum infectious complication in preeclampsia has proved to be incorrect.
Conclusion. Chronic arterial hypertension complicates the course of pregnancy 10.8 times more frequently in puerperas with endometritis after caesarean section (8.6% vs. 0,8%; χ2=17,11; p<0,001). It makes possible to refer this hypertension to significant predictors of developing of infectious and inflammatory complications. It requires a more careful monitoring of the pregnant woman and the puerperal to prevent this type of complications. It can also serve as the basis for the subsequent construction of a prognostic risk model.

About the Autors

Corresponding author: Nikolay A. Korobkov, Cand. Sci. (Med.), Associate Professor at the Department of Obstetrics and Gynecology n.a. S.N. Davydov, North-Western State Medical University n.a. I.I. Mechnikov, St. Petersburg, Russia; 

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