V.F.Snegirev Archives of Obstetrics and GynecologyV.F.Snegirev Archives of Obstetrics and GynecologyАрхив акушерства и гинекологии им. В.Ф. Снегирева2313-87262687-1386Eco-Vector3542710.18821/2313-8726-2018-5-1-4-8Original study articlesОригинальные исследованияOriginal study articlesReview ArticleBLOOD VOLUME AND HEMODYNAMIC CHANGES IN PREGNANTS, PARTURIENTS AND PUERPERAEВОЛЕМИЧЕСКИЕ И ГЕМОДИНАМИЧЕСКИЕ ИЗМЕНЕНИЯ У БЕРЕМЕННЫХ, РОЖЕНИЦ И РОДИЛЬНИЦRonensonAleksandr M.РоненсонАлександр Михайлович

MD, Head of the Department of Anaesthesiology and Reanimation of the E.M. Bakunina Regional clinical perinatal center, Tver, 170036, Russian Federation

зав. отд-нием анестезиологии и реанимации ГБУЗ Тверской области «Областной клинический перинатальный центр им. Е.М. Бакуниной», г. Тверь

a.ronenson@mail.ruShifmanE. MШифманЕ. МKulikovA. VКуликовА. ВE.M. Bakunina Regional clinical perinatal centerГБУЗ Тверской области «Областной клинический перинатальный центр им. Е.М. Бакуниной»M.F. Vladimirsky Moscow Regional Research and Clinical InstituteГБУЗ МО «Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского»Ural State Medical AcademyГБОУ ВПО «Уральская государственная медицинская академия» Минздрава России1503201851VOL 5, NO1 (2018)ТОМ 5, №1 (2018)4821072020Copyright ©; 2018, Eco-VectorCopyright ©; 2018, ООО "Эко-Вектор"2018Eco-VectorООО "Эко-Вектор"https://archivog.com/2313-8726/article/view/35427

In the article, there are considered questions of physiological changes of the blood volume status during pregnancy, parturition and in the postpartum period, features of functional and structural changes of the cardiovascular system. The determination of the circulating blood volume is still a stumbling block for obstetrician-gynecologists and anesthesiologists-resuscitators. Our view of the normal blood volume status during pregnancy is important in light of the assessment of the blood loss in the development of massive obstetric hemorrhage. The doctor needs to know what changes in the cardiovascular system are physiological and which are pathological in case of blood loss, with taking into account the functional changes in the heart that occur during pregnancy, parturition and in the earliest postpartum period. A deeper understanding of this problem will help the doctor avoid aggressive infusion therapy, which can lead to complications.

В статье рассмотрены вопросы физиологических изменений волемического статуса во время беременности, родов и в послеродовом периоде, особенности функциональных и структурных изменений сердечно-сосудистой системы. Определение объёма циркулирующей крови до сих пор является камнем преткновения для акушеров-гинекологов и анестезиологов-реаниматологов. Наше представление о нормальном волемическом статусе во время беременности важно в свете оценки кровопотери при развитии массивного акушерского кровотечения. Врачу необходимо знать, какие изменения в работе сердечно-сосудистой системы являются физиологическими, а какие патологическими при кровопотере, с учётом функциональных изменений в работе сердца, происходящих во время беременности, родов и в ближайшем послеродовом периоде. Более глубокое понимание этой проблемы поможет врачу избегать агрессивной инфузионной терапии, которая может привести к осложнениям.

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