CHANGES IN THE STRUCTURE OF THE DAILY BLOOD PRESSURE PROFILE IN WOMEN WITH THE METABOLIC SYNDROME WHO HAD CESAREAN SECTIONS UNDER THE INFLUENCE OF PHYSICAL THERAPY
Authors: Sheremeta L.M. , Ostapiak Z.M. 
Published: July 2023

Abstract. Purpose: determination of the effectiveness of the use of physical therapy in women with metabolic syndrome who underwent caesarean section, based on changes in the structure of the daily blood pressure profile.

Methods. During the research, 44 women aged 25.5±1.6 years at the end of the late postpartum period (2 months after childbirth) were examined. The control group consisted of 17 women with normal body weight who gave birth vaginally and recovered independently in the postpartum period. The comparison group consisted of 14 women with the metabolic syndrome who independently recovered in the postpartum period. The experimental group consisted of 13 women with metabolic syndrome after caesarean section, who for 3 months performed restorative measures developed as part of a proven physical therapy program. They included classes using therapeutic exercises for the muscles of the back, abdomen, and limbs, functional training with adaptation to household movements and child care taking into account obesity and the postpartum period with caesarean section, aerobic training, pressotherapy and vacuum massage for areas with the greatest deposition of fatty tissue; nutritional recommendations – reducing daily caloric intake. Daily monitoring of blood pressure was carried out to determine its profile by the types "diрper", "non-dipper", "over-dipper", "night-peaker".

Results. During the initial examination, it was established that, in general, women with a normal body weight have a "dipper" daily blood pressure profile. This most favorable type of decrease in arterial pressure at night was characteristic of almost 70% of representatives of this group. At the same time, in women with metabolic syndrome after caesarean section, such a profile was established in slightly more than half of the cases. On the other hand, in the groups of women after caesarean section, a significant share (about a third) was made up of the "non-dipper" and "over-dipper" profiles, which have an unfavorable character. One of the signs of adverse daily dynamics of blood pressure in women with metabolic syndrome is the diagnosis of their circadian rhythm according to the "night-peaker" profile.

The following results were revealed during the re-survey, which was conducted to assess the effectiveness of the developed physical therapy program. The share of persons with a favorable profile of "dipper" systolic blood pressure increased. This redistribution took place due to the reduction of the share of persons with unfavorable "non-dipper" profiles and the complete disappearance of persons with the daily blood pressure profile "night-peaker" profile. Similar trends were also observed in the analysis of daily diastolic blood pressure profiles.

Analysis of daily blood pressure profiles of women after vaginal delivery revealed that they had a higher percentage of women with normal profiles in the early periods of observation; further dynamics were favorable. Re-examination of comparison group women showed an increase in the number of women with favorable profiles, but it was not as pronounced as in experimental group women, which demonstrates the benefits of a proven physical therapy program.

Conclusion. It is advisable to prescribe physical therapy to correct the indicators of the daily profile of blood pressure in women with metabolic syndrome in the postpartum period, which prognostically reduces the risk of cardiovascular disasters in them.