Objective — to establish the features of the course of pregnancy and labor, neonatal status, and placental structural rearrangement in fetal growth restriction in pregnant women with chronic hypertension and secondary preeclampsia. Subject and methods. The course of pregnancy, and labor and neonatal status were retrospectively analyzed in 14 patients with chronic hypertension concurrent with secondary preeclampsia and fetal growth restriction and in 16 pregnant women with chronic hypertension and secondary preeclampsia with and without fetal growth restriction. Placental pathomorphological examination encompassed macroscopic diagnosis, organometry, and survey histological examination. Results. The major factors of fetal growth restriction in pregnant women with chronic hypertension and secondary preeclampsia are early-onset preeclampsia, grades II, III placental hypoplasia concurrent with impaired differentiation of a vasculostromal component of villi, with chronic maternal-fetal circulatory disorders in the presence of the low compensatory potential of villous chorionic structures. Conclusion. The absence of significant differences in the shape of placentas and in the types of attachment of the umbilical cord, in the rate and pattern of other maternal and fetal circulatory disorders in the placentas in chronic hypertension, preeclampsia with and without fetal growth restriction is likely to be related to the presence of additional factors for fetal growth disorders. One of these factors is evidently no prehospital antihypertensive therapy for chronic hypertension in pregnant women. The authors declare no conflicts of interest.