Anatomical and physiological changes in the venous system of lower limbs in pregnant women and findings associated with the symptomatology

Goulart, Vitória Brito; Cabral, Antônio Carlos Vieira; Reis, Zilma Silveira Nogueira; Navarro, Túlio Pinho; Alves, Silvia Lúcia; Miranda, Paulo Roberto Toledo de; Sarquis, Alberto Lourençoni; Rezende, Cézar Alencar de Lima

doi:10.1007/s00404-013-2728-9

Cited by 16 publications

(11 citation statements)

References 9 publications

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“…Several changes occur in the lower limb venous system during pregnancy. 1 Venous volume (VV) and pressure are increased, causing venous distension and stasis. 2 Oestrogen and progesterone also determine increased distensibility in the venous wall.…”

Section: Introductionmentioning

confidence: 99%

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Lower limb venous diameters and haemodynamics during pregnancy and postpartum period in healthy primigravidae

et al. 2016

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Objective Analyse venous haemodynamics in healthy primigravidae during pregnancy and in the postpartum. Methods Cohort with primigravidae evaluated in the three trimesters of pregnancy and postpartum. Duplex evaluated venous diameters and reflux; air plethysmography evaluated venous filling index, ejection fraction, residual volume fraction and outflow fraction in both limbs. Results During pregnancy, diameters increased in bilateral common femoral and right infravalvar great saphenous, but returned to first trimester values after delivery. Reflux developed in one woman (5%) in the second trimester and in two more women (15%) in the third trimester. No reflux was detected in postpartum. Bilateral venous filling index was higher during pregnancy. Bilateral ejection fraction and residual volume fraction did not change. Bilateral outflow fraction increased progressively. The right limb outflow fraction in left lateral decubitus was similar. All changes returned to first trimester values after delivery. Conclusions Healthy primigravidae presented changes in lower limbs' veins during pregnancy: diameters in bilateral common femoral and infravalvar great saphenous veins increased; new reflux was developed in 15% of women, but there was no venous hypertension. Calf muscular pump function did not change. All changes returned to first trimester values after delivery.

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Section: Introductionmentioning

confidence: 99%

“…The few available studies have a lack of standardisation of inclusion criteria. 1,6 The objective of this study was to analyse venous haemodynamics in healthy primigravidae during the first, second and third trimesters of pregnancy and in the postpartum period.…”

Section: Introductionmentioning

confidence: 99%

Lower limb venous diameters and haemodynamics during pregnancy and postpartum period in healthy primigravidae

et al. 2016

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“…Different outcomes have been analyzed in studies examining the venous changes during gestation, such as vein diameter, venous reflux, venous stasis; these studies identified a deterioration in these parameters at the end of the gestational period. 16,17 The exact mechanism of venous reflux has not yet been fully elucidated; however, it is known that the probable mechanisms involved in its development are related to changes in the integrity of the valves, the walls of the veins and unfavorable hemodynamics of the venous blood flow. These components are interdependent and any imbalance in one of them affects the integrity of the others, compromising the normal functioning of the venous system.…”

Section: Discussionmentioning

confidence: 99%

Compression stocking prevents increased venous retrograde flow time in the lower limbs of pregnant women

2020

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Objectives To analyze the effect of graduated compression stockings on the venous reflux in the lower limbs of pregnant women. Method A controlled randomized clinical trial was performed with sixty women: intervention group (n = 30), who used compression stockings, and control group (n = 30). Using duplex-ultrasound, the reflux time and peak reflux velocity in the great saphenous vein and small saphenous vein were analyzed. Results Great saphenous vein reflux times in the intervention group were 0.13 s at the beginning (initial) and 0.04 s at the end of pregnancy (final) in the right leg and 0.02 s and 0.34 s (p < 0.0001) in the control group. No patient in the intervention group experienced pathological reflux at the end of the pregnancy. There was a significant difference in the reflux time measured from both the great saphenous vein and small saphenous vein and peak reflux velocity between the groups. Conclusion Compression stockings prevent increased venous reflux in lower limbs of pregnant women.

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“…15 In leg Doppler ultrasound studies of pregnant patients, there were decreased flow velocities and increased vein diameters starting in early first trimester that peaked at 36 weeks of gestation, with increased venous stasis seen in the left leg veins compared with the right. 16,17 Epidemiological studies support these ultrasound findings: more than 80% of DVTs are diagnosed in the left leg, with the majority of DVTs restricted to the iliac and/or femoral veins. 12,18 Vascular damage during pregnancy and in the peripartum period contributes to the increased risk of VTE.…”

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confidence: 88%

Pulmonary Complications of Pregnancy: Venous Thromboembolism

Skeith

Rodger

2017

Semin Respir Crit Care Med

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Unique considerations are needed when diagnosing and treating venous thromboembolism (VTE) in women who are pregnant or postpartum. What are the risks to the fetus, such as drug exposure or the risk of radiation with diagnostic imaging? How does the physiology of pregnancy affect imaging techniques and anticoagulation management? How should anticoagulation be managed around labor and delivery? These questions highlight some of the important considerations needed when managing a pregnant patient with suspected or confirmed VTE. This review outlines what is known about the epidemiology, pathophysiology, clinical risk factors, diagnosis, and therapeutic management of VTE in pregnancy. We also review our preferred diagnostic and treatment algorithm for a pregnant patient with suspected or confirmed VTE.

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Anatomical and physiological changes in the venous system of lower limbs in pregnant women and findings associated with the symptomatology

Cited by 16 publications

References 9 publications

Lower limb venous diameters and haemodynamics during pregnancy and postpartum period in healthy primigravidae

Lower limb venous diameters and haemodynamics during pregnancy and postpartum period in healthy primigravidae

Compression stocking prevents increased venous retrograde flow time in the lower limbs of pregnant women

Pulmonary Complications of Pregnancy: Venous Thromboembolism

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