Možnosti predikce těhotenstvím indukované hypertenze u žen s rizikovými faktory

Possible Prediction of Pregnancy-inducedHypertension in Women with Risk Factors

The objective of the presented work was to find possible predictive factors of pregnan-cy-induced hypertension (PIH) in women with the risk of gestational diabetes (GDM) duringpregnancy. A group of women with the risk of development of gestational diabetes was selectedbecause it is known that in women with GDM a hypertension is encountered 2-4 times morefrequently than in women without disorders of glucose tolerance during pregnancy. The patientswere divided into four groups with regard to the risk of development of hypertension. The exami-nations were made once during the 20th week of gestation. PIH is manifested in the great majori-ty of patients only after the 20th week of pregnancy. All patients were normotensive at the time ofexamination. During the subsequent course of pregnancy in all patients the diagnosis of gestatio-nal diabetes and pregnancy-induced hypertension was investigated.The investigated parameters were fasting insulin levels during the 20th week of gestation, coagu-lation factors - antithrombin III (AT III), D-dimer, number of thrombocytes. The authors investi-gated also anamnestic data on the presence of type II diabetes and hypertension in close relativesof the patients.Results: No differences were found in the insulin, antithrombin III and D-dimer levels nor in thenumber of thrombocytes.A significant relationship was revealed between the incidence of hypertension during pregnancyand the family history of the patient. In women where there was diabetes type 2 and hypertensionin the family, there was a markedly more frequent incidence of pregnancy-induced hypertensionafter the 20th week of pregnancy (p > 0.0002) than in the other investigated groups.This work was supported by the Grant Agency of the Ministry of Health of the Czech Republic -grant No. 3320-3.

Key words: