Статья
Ведение артериальной гипертензии у женщин после родов (обзор литературы)
Проведен обзор литературы по краткосрочному и долгосрочному ведению женщин с артериальной гипертензией (АГ) после родов. Приводятся риски для будущего здоровья женщин, перенесших гипертензивные состояния во время беременности (гестационную АГ, преэклампсию). Рассматриваются немедикаментозные и лекарственные методы управления сердечно-сосудистыми рисками у женщин с неблагоприятными исходами беременности. Приводятся особенности межгестационного ухода за женщинами с АГ. Перечисляются причины прекращения грудного вскармливания у матерей с АГ. Рассматриваются медицинские, этические и юридические вопросы принятия решения об использовании антигипертензивных лекарств во время лактации. Перечисляются источники получения информации о совместимости лекарственных средств и грудного вскармливания. Приводятся данные о допустимости приема антигипертензивных препаратов при лактации, предоставляемые базой LactMed и производителями оригинальных лекарственных средств, продаваемых в России. Рассматривается актуальность атерогенной дислипидемии у женщин с АГ после родов и оценивается возможность и необходимость назначения гиполипидемических препаратов (статинов, эзетимиба и ингибиторов PCSK9) при лактации. Приводятся доказанные (аспирин, кальций) и исследуемые (метформин, статины, гидроксихлорохин) меры профилактики преэклампсии. Сообщается о создании мультидисциплинарных клиник материнского здоровья для женщин с анамнезом АГ беременности.
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