Variability of cardiac disorders during pregnancy as a factor of extragenital pathology

Vinogradova Olga Pavlovna, Rakhmatullov Fagim Kasymovich, Ostanin Maxim Aleksandrovich

Introduction. The paper considers cardiac disorders in the process of physiologically occurring pregnancy, the effect of these rhythm disturbances on the course and outcomes of pregnancy, as well as the possibility of using drug correction of arrhythmogenic status. A promising direction is the development of a plan for early diagnosis of rhythm disturbances that manifest themselves during pregnancy. Cardiac arrhythmias and conduction disorders during pregnancy remain one of the main and quite important problems both from the point of view of finding possible causes of their occurrence, and from the point of view of methods, approaches to treatment and prognosis for the mother and fetus. Goal. Detection of cardiac arrhythmias in the early stages of pregnancy with dynamic monitoring of trimesters of pregnancy. The possibility of correlation of the detected rhythm disturbances with further prediction of pregnancy outcomes. Materials and methods of research. The instrumental method of diagnosis was the daily monitoring of the electrocardiogram by Holter (Holter ECG 3/12-"Cardio-Astel" (CARDIODM-3). The study was conducted on trimesters of pregnancy. The results of the study. According to the 24-hour Holter monitoring of the electrocardiogram, ventricular extrasystoles are most often registered in the examined pregnant women of the I-III trimesters of pregnancy - 62%. In 3.6% of pregnant women, ventricular extrasystoles were combined with WPW syndrome. 64% of the examined pregnant women have supraventricular extrasystoles. Combination with short-term paroxysms of supraventricular tachycardia was rarely observed (5.4%), WPW syndrome was also encountered (3.6%). Violation of the impulse was quite rare: only 9.2% of pregnant women had atrioventricular and sinoatrial blockade of I-II degree. Persistent paroxysms of atrial fibrillation lasting more than 30 seconds were detected in 5 patients. The total increase in atrial fibrillation in trimesters was 25.7%. An increase in the duration of atrial fibrillation in the third trimester of pregnancy gives an unfavorable prognosis in terms of progression from paroxysmal to persistent form. Conclusions. Cardiac arrhythmias during pregnancy are quite common. The presence of even such a potentially malignant arrhythmia as frequent ventricular extrasystole with paroxysms of stable ventricular tachycardia, accompanied by fainting states, did not require termination of pregnancy, and minimal antiarrhythmic therapy allowed, with proper supervision, to effectively correct the symptoms and allowed prolongation of pregnancy. The asymptomatic course of arrhythmias is accompanied by a large number of detectable extrasystoles and tachycardia paroxysms. Untimely diagnosis of asymptomatic arrhythmias can lead to the development of complications leading to adverse pregnancy outcomes.

Keywords:Pregnancy, cardiac arrhythmias, arrhythmias, diagnostics.