COURSE OF PREGNANCY IN WOMEN WITH VARICOSE DISEASE
1Local Maternity Hospital № 2, Health Department of Khukumat of Dushanbe City, Dushanbe, Tajikistan
2Republican Scientific Center for Cardiovascular Surgery, Dushanbe, Tajikistan
3Avicenna Tajik State Medical University, Dushanbe, Tajikistan
Objective: Evaluation of the influence of varicose disease on the course and outcome of pregnancy.
Methods: A comparative analysis of the pregnancy course was carried out in 24 women with varicose disease (the main group) and 24 pregnant women without it (control group). Both groups for age and pregnancy were comparable. The average age of women in both groups was 27.2± 3.1 years. Criteria of exceptions from the groups were preeclampsia and concomitant severe extragenital diseases. According to the clinical classification of CEAP, 20 patients had clinical grade II (C2), in 4 patients – clinical class III (C3) of chronic venous insufficiency. The combined varicose veins of great saphenous vein and its inflows, the veins of the vulva and the vagina were noted in 10 (41.7%) patients, isolated expansion of the trunk of the great saphenous vein and its inflows in 12 (50%) pregnant women, and pelvic congestion syndrome, dilatation of great saphenous vein and veins of the external genitals – in 2 (8.3%) cases.
Results: At the end of the second trimester, 10 (41.7%) of the pregnant (main group) had dysuric disorders, whereas, in the control group only 1 (4.2%) observed these events. The incidence of placental insufficiency in patients of the main group (n = 12; 50%) was higher than in the control group (n = 1; 4.2%). The threat of interrupt pregnancy in the main group was registered in 14 (58.3%) cases, in the control group – only in 1 (4.2%) patients (p>0.05). The intrauterine growth retardation of a fetus was noted in 3 (12.5%) patients of the main group. In the main group, hydramnion were in 4 (16.7%) patients, whereas in the pregnant women of the control group, it occurred only in 1 (4.2%) cases (p> 0.05). In 4 (8.3%) patients of both groups, there was an edematous variant of gestosis, with a significant difference: in 3 (12.5%) patients in the main and in 1 (4.2%) control groups.
Conclusions: The varicose disease leads to an increase in the development of various severe complications of gestation, which requires a comprehensive and timely correction.
Keywords: pregnancy, varicose veins, threat interruption of pregnancy, intrauterine growth retardation of fetus, outcomes.
- Bogachyov VYu. Varikoznaya bolezn' ven malogo taza [Varicose of pelvic veins]. Ginekologiya [Gynecology]. 2006;8(4):64-5.
- Ivanov EV, Nizamov FH, Mihaylova AV. Techenie beremennosti i rodov u zhenshchin, stradayushchikh varikoznoy bolezn'yu nizhnikh konechnostey [Pregnancy and delivery in women with lower limb varicosity]. Meditsinskaya nauka i obrazovanie Urala [Medical science and education of Ural]. 2012;13(71):5-7.
- Marizoeva MM, Sadriev ON, Kalmykov EL, Sultanov DD, Bobdzhonova OB. Techenie rodov u zhenshchin s varikoznoy bolezn´yu [Parturition in women with varicose disease]. Rossiyskiy mediko-biologicheskiy vestnik imeni akademika I.P. Pavlova [I.P. Pavlov Russian Medical Biological Herald]. 2017;25(1): 97-102. Available from: http://dx.doi/10.23888/PAVLOVJ2017197-102.
- Sultanov DD, Gaibov AD, Kalmykov EL, Mallaev SH. Faktory riska razvitiya varikoznoy bolezni u sel'skikh zhiteley yuzhnogo regiona Tadzhikistana [Risk factors of varicosity development in rural residents of the southern region of Tajikistan]. Novosti khirurgii [Surgery news]. 2012;20(4):48-51.
- Dzhobava EM, Stepanyan AV, Panayotidi DA, Bolkunova NV, Dobrokhotova YuE. Osobennosti techeniya, diagnostiki i terapii platsentarnoy nedostatochnosti pri varikoznoy bolezni [The course features, diagnosis and treatment of placental insufficiency in varicosity]. Akusherstvo, ginekologiya i reproduktsiya [Obstetrics, Gynecology and Reproduction]. 2011;5(4):13-9.
- Lim CS, Davies AH. Pathogenesis of primary varicose veins. Br J Surg. 2009;96(11):1231-42. Available from: http://dx.doi/10.1002/bjs.6798.
- Mozheyko LF, Tikhonovich EV, Perepelitsa SI. Osobennosti techeniya beremennosti i rodov u patsientok s khronicheskoy venoznoy nedostatochnost'yu [Aspects of pregnancy and labor in patients suffering from chronic venous insufficiency]. Reproduktivnoe zdorov'e Vostochnaya Evropa [Reproductive health Eastern Europe]. 2016;4(46):519-25.
- Tsukanov YuT, Kravchenko EN, Krivorotov IA, Vasilevich VV. Osobennosti klinicheskogo techeniya beremennosti i rodov u zhenshchin s varikozom ven vul'vy, vlagalishcha i promezhnosti [Specific features of the clinical course of pregnancy and labor in the women with varicose veins of vulva, vagina, and perineum]. Flebologiya [Phlebology]. 2013;7(2):21-5.
- Kravchenko EN, Tsukanov YuT, Krivorotov IA. Akusherskie aspekty varikoznogo rasshireniya ven vul'vy, vlagalishcha i promezhnosti u beremennykh [Obstetric aspects of varicose veins of the vulva, vagina and perineum]. Problemy reproduktsii [Russian Journal of Human Reproduction]. 2013;4:85-9.
- Kamilova MYa, Kasymova ShS. Osobennosti techeniya beremennosti i perinatal'nye iskhody u zhenshchin s varikoznoy bolezn'yu [Features of gestation course and perinatal outcomes in women with varicose disease]. Vestnik Avitsenny [Avicenna Bulletin]. 2016;3:47-51.
- Shemerovskiy KA, Toshtemirova ZM, Tabarov MS, Saidmurodova RA, Hodjaeva MH. Sravnitel'naya kharakteristika faktorov riska varikoznoy bolezni [Comparative characteristics of factors of risk under varicose disease]. Vestnik Avitsenny [Avicenna Bulletin]. 2010;1:115-9.
- Dijkstra ML, Khin NY, Coroneos JC, Hazelton S, Lane RJ. The effect of pregnancy on venous valve repair to the sapheno-femoral junction for varicose veins. Obstet Med. 2014;7(2):84-9. Available from: http://dx.doi/ 10.1177/1753495X14522617.
- Tsukanov YuT, Vasilevich VV, Tsukanov AYu, Kornienko IF. Klinicheskie i gemodinamicheskie osobennosti varikoznogo rasshireniya ven vul'vy i promezhnosti vo vremya i vne beremennosti [Clinical features and hemodynamics of vulvular and perineal varicosis in pregnant and non-pregnant women]. Flebologiya [Phlebology]. 2008;4:27-32.
- Akusherstvo: natsional'noe rukovodstvo [Obstetrics: national guideline]. Pod red. Aylamazyana EK, Kulakova VI, Radzinskogo VE, Savel'evoy GM. Moscow, RF: GEOTAR-Media; 2007. 1200 p.
- Tsukanov YuT, Tsukanov AYu, Levdanskiy EG. Porazhenie tazovykh organov pri vtorichnom varikoznom rasshirenii ven malogo taza [Lesion of pelvic organs in secondary varicose veins of the small pelvis]. Angiologiya i sosudistaya khirurgiya [Angiology and vascular surgery]. 2015;21(2):94-100.
- Beznoshchenko GB, Kravchenko EN, Tsukanov YuT, Kropmaer KP, Tsygankova OYu. Varikoznaya bolezn' u beremennykh: osobennosti gestatsionnogo perioda, flebogemodinamika malogo taza i nizhnikh konechnostey [Varicose veins in pregnant women: Specific features of a gestational period, phlebohemodynamics of the small pelvis and lower limbs]. Rossiyskiy vestnik akusher-ginekologa [Russian Bulletin of Obstetrician-Gynecologist]. 2016; 16(3):4-8.
Marizoeva Mahina Mahmadulloevna, Doctor, the obstetrician-gynecologist of the Local Maternity Hospital № 2 of the Dushanbe City Health Department
Nematzoda Okiljon, Candidate of Medical Sciences, Leading Researcher of the State Institution "Republican Scientific Center for Cardiovascular Surgery"
Sultanov Javli Davronovich, Doctor of Medical Sciences, Full Professor, Head of the Department of Science of State Institution "Republican Scientific Center for Cardiovascular Surgery", Professor of the Department of Surgical Diseases № 2, Avicenna Tajik State Medical University
Nazirova Gulnora Obidovna, Doctor, the obstetrician-gynecologist of the Local Maternity Hospital № 2 of the Dushanbe City Health Department
Ismatova Umiya Subhonovna, Doctor, the obstetrician-gynecologist of the Local Maternity Hospital № 2 of the Dushanbe City Health Department
Bobdzhonova Oksana Bobdzhonovna, The Clinical Resident of the Department of Obstetrics and Gynecology№ 2, Avicenna Tajik State Medical University
Address for correspondence:
Candidate of Medical Sciences, Leading Researcher of the State Institution "Republican Scientific Center for Cardiovascular Surgery"
734003, Republic of Tajikistan, Dushanbe, Sanoi street, 33
Tel.: (+992) 915 250055
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