In 56 pregnant women, the diagnosis of preeclampsia was verified in the course of the study using a three-stage system for assessing the severity of preeclampsia, with the determination of the type of central hemodynamics, blood osmolarity, the biophysical profile of the fetoplacental complex (FPC), its functional state (8 of moderate severity and 48 of mild severity). In 32 pregnant women, the hypertensive condition was due to somatic pathology (pyelonephritis, hypothalamic syndrome, thyrotoxicosis and hypertension). In pregnant women with preeclampsia, all deliveries were urgent. At the same time, in 8 (14.3%) women, childbirth ended with cesarean section due to the inferiority of the scar on the uterus (4) and the ineffectiveness of the treatment of preeclampsia (4). In pregnant women with hypertension, premature birth in the period from 35 to 37 weeks occurred in 3 (3.4%) cases. In this group, surgical delivery was performed in 13 (14.8%) women due to the presence of a scar on the uterus and a violation of its contractile activity. There were no perinatal losses in the studied groups of women.

The condition of newborns in the first group in 4(4.5%) women was of moderate severity, in 8 (9%) - asymmetric fetal hypotrophy of mild (5) and moderate (3) severity was noted. In the second group, the condition of moderate severity was noted in 5(8.9%) newborns, asymmetric hypotrophy in 7 (12.5%). Of which, 4 newborns were found to have hypotrophy of the second degree and 3 of the first. All women received hypotensive therapy with calcium antagonists, beta-blockers and magnesium sulfate according to Federal standards. For the differential diagnosis of preeclampsia and arterial hypertension, 6 evaluation criteria proposed by prof.N. A. Zharkin (2000) were used as prognostic signs of preeclampsia: average blood pressure, the index of hypertension time, the index of the area under the curve of high blood pressure, the indicator of blood pressure variability, the indicator of daily rhythm, pulse and average dynamic blood pressure. In the course of the study, it was noted that the only significant differences in the differential diagnosis of preeclampsia and hypertension of pregnant women are the indicators of the index of t me, area, variability and average dynamic blood pressure. So, the average indicator of the time index, indicating the percentage ratio of the time of high blood pressure to the entire follow-up time in the group of women with preeclampsia, for systolic blood pressure was 55.3±2.1%, for diastolic 59.6±1.9%. While for hypertensive conditions, these indicators were respectively equal to 13.3±0.9% and 22.7±0.8%. (P<0.005). At the same time, an increase in the index indicated the effectiveness of the therapy. The indicator of the area under the blood pressure curves for women with preeclampsia was 122.8±1.6 mm2. for systolic blood pressure and 119.1±1.4 mm2. for diastolic. In women with hypertension, these indicators were 81.6±0.5 mm2. and 35.3±0.4 mm2. and were significantly different in both groups (P<0.01). At the same time, the indicators of the daily blood pressure rhythm in the groups of women with preeclampsia and hypertension did not significantly differ, averaging 14.5±1.9% and 16.4±0.6%, respectively (P>0.01). Normal indicators of this evaluation criterion range from 10 to 20%. decree.

The levels of variability of systolic and diastolic blood pressure showed a significant decrease in variability in the group of women with preeclampsia and a decrease in the variability of night blood pressure in women with hypertension. The average values of pulse pressure in both groups did not significantly differ, averaging 48.4±3.4 mmHg for preeclampsia and 52.8±1.9 mmHg (P>0.01) for hypertension in pregnant women. The average dynamic pressure was calculated using the formula: SDD = DB + 1/3(SAD – DAD) mmHg, where DBP is diastolic blood pressure, SAD is systolic blood pressure, was calculated using the formula: SDD = DB + 1/3(SAD – DAD) mmHg, where DBP is diastolic blood pressure, SAD is systolic blood pressure, and was significantly higher (P≤0.01) in the group of women with preeclampsia, averaging 102±0.6 mmHg, compared with the groups of women with hypertension (89.2±0.2 mmHg) and a normally developing pregnancy (87.1±0.8 mmHg). At the same time, the difference in the average indicators of the average dynamic pressure in the first and third groups of women were also significantly different (P≤0.01). mm2.

When assessing the level of TBG, it was noted that in the first group of women represented by pregnant women with mild and moderate preeclampsia, the average level of TBG was 0.042±0.01 g / l. At the same time, the average level of TBG among pregnant women with mild preeclampsia was 0.0523±0.01 g/l. In none of the observations, the TBG index in this group of women did not exceed 0.07 g / l, and among women with moderate preeclampsia was 0.035±0.015 g / l(P>0.01). In the group of women with hypertension of pregnant women, the average level of TBG was 0.096±0.01 g / l. and it was significantly (P<0.01) higher than the average TBG index among women whose pregnancy was complicated by mild and moderate preeclampsia. At the same time, in none of the observations, the TBG level did not exceed the indicator of 0.12 g/l. In women of the control group (15), with a normal pregnancy, the average TBG level was 0.157±0.01 g / l and was significantly (p<0.005) higher than in the first and second groups and was not lower than 0.14 g/l in any of the observations.

Thus, for the differential diagnosis of preeclampsia and gestational hypertension, it is necessary to conduct SMAD with an assessment of the time index, the area under the curve of high blood pressure, variability and the indicator of average dynamic blood pressure. At the same time, preeclampsia is characterized by: the time index is more than 50%, the area index is more than 110 m2, the variability does not exceed 12 mm Hg, and the average dynamic blood pressure is more than 100 mm Hg.

In preeclampsia, the TBG level does not exceed 0.07 g/l. The level of TBG in hypertension of pregnant women is significantly less than in a normal pregnancy, but it is significantly higher than in preeclampsia of pregnant women of any severity and does not exceed the indicator of 0.12 g/l.

The characteristic features of the SMAD indicators for hypertension of pregnant women were a decrease in the nocturnal variability of blood pressure and not exceeding the average dynamic blood pressure of 100 mm Hg.