Graduated compression stockings effects on chronic venous disease signs and symptoms during pregnancy

Saliba, Orlando Adas; Rollo, Hamilton Almeida; Saliba, Orlando; Sobreira, Marcone Lima

doi:10.1177/0268355519846740

Cited by 15 publications

(10 citation statements)

References 23 publications

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“…Pregnancy produces important changes in the tissues and homeostasis of women and the most important are those related to the cardiovascular system, such as an increase in blood volume and alterations in systemic vascular resistance ( 1 – 3 ). Numerous studies have shown how the venous system is affected during pregnancy, particularly with the development of chronic venous disease (CVD), which is clinically diagnosed by the presence of varicose veins ( 2 – 4 ). As CVD progresses, there is a simultaneous decrease in blood flow velocity ( 5 ), an increase in leg vein diameter ( 6 ) and valve closure time ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

An increase in elastogenic components in the placental villi of women with chronic venous disease during pregnancy is associated with decreased EGFL7 expression level

et al. 2021

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Chronic venous disease (CVD) is the response to a series of hemodynamic changes in the venous system and the onset of this disease is often triggered by pregnancy. Placental tissue is particularly sensitive to the characteristic changes which occurs in venous hypertension. In this regard, changes in the extracellular matrix (ECM), that occur to adapt to this situation, are fundamental to controlling elastogenesis. Therefore, the aim of the present study was to analyze the changes that occur in the mRNA and protein expression level of proteins related to elastogenesis in the placental villi of women diagnosed with CVD, in the third trimester of pregnancy. An observational, analytical and prospective cohort study was conducted, in which the placenta from 62 women with CVD were compared with that in placenta from 52 women without a diagnosis of CVD. Gene and protein expression levels were analyzed using reverse transcription-quantitative PCR and immunohistochemistry, respectively. The results showed a significant decrease in the gene and protein expression level of EGFL7 in the placental villi of women with CVD. By contrast, significant increases in the gene and protein expression level of ECM-related proteins, such as tropoelastin, fibulin 4, fibrillin 1 and members of the lysyl oxidase family (LOX and LOXL-1) were also found in the placental villi of women with CVD. To the best of our knowledge, the results from the present study showed for the first time that CVD during pregnancy was associated with changes in the mRNA and protein expression level in essential components of the EGFL7-modulated elastogenesis process in placental villi.

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Section: Introductionmentioning

confidence: 99%

An increase in elastogenic components in the placental villi of women with chronic venous disease during pregnancy is associated with decreased EGFL7 expression level

et al. 2021

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“…22,23 Previous studies have demonstrated that compression stockings are effective in controlling the GSV and SSV diameters and reducing the signs and symptoms of pain, edema, and leg heaviness related to pregnancy. 12 The compression required to achieve the desired effects and the effect of the compression on the volume of the limbs are important issues when they are related to the effectiveness of the compression stockings.…”

Section: Discussionmentioning

confidence: 99%

“…It should be noted that the groups did not differ statistically in age, initial weight, height, and gestational week at the beginning of the study. 12…”

Section: Discussionmentioning

confidence: 99%

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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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“…3 Pregnant women with varicose veins have exacerbation of their venous symptoms during this period with significant problems including leg oedema (in up to 80% of women) along with night cramps, numbness, tingling, itching and throbbing with additional complication of superficial and deep vein thrombosis and pulmonary embolism. 4,5…”

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confidence: 99%

A need for evidence to guide treatment recommendation for women with chronic venous disease during childbearing years

et al. 2020

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Pregnancy is a well-known and important risk factor for the development of primary and recurrent varicose veins. 1,2 The reasons for this are secondary to hormonal and mechanical issues, including the effect of progesterone on the veins along with the compressive effect of the foetus causing increased venous pressure in the leg. 3 Pregnant women with varicose veins have exacerbation of their venous symptoms during this period with significant problems including leg oedema (in up to 80% of women) along with night cramps, numbness, tingling, itching and throbbing with additional complication of superficial and deep vein thrombosis and pulmonary embolism. 4,5 In general, pregnant women with symptomatic varicose veins are offered compression stockings either class (14-17mmHg) and (18-24mmHg) in degree or advised to elevate their legs as much as possible. 6-8 This can be difficult in warmer climates and when patients are in late stages of their pregnancy. Symptoms tend to worsen as the pregnancy progresses with increasing leg oedema. It is known that the majority of these symptoms do improve post gestation, usually within three months. 9 However, the rate of compliance of stockings is poor with up to 40% either refusing to wear stockings or non-compliant during their pregnancy. 6 Controversy exists as to whether patients should be advised to have venous intervention between pregnancies or wait until they have completed their family. The reason for advocating delay was a perceived higher recurrence rate following open surgery (20-40%) which would have then required redo-surgery in the groin with its associated morbidity. 10 However, with emerging technologies, it is possible to now treat recurrent veins with minimally invasive techniques, thus reducing the morbidity associated with recurrent groin surgery. It is worth noting at this point that

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Graduated compression stockings effects on chronic venous disease signs and symptoms during pregnancy

Cited by 15 publications

References 23 publications

An increase in elastogenic components in the placental villi of women with chronic venous disease during pregnancy is associated with decreased EGFL7 expression level

An increase in elastogenic components in the placental villi of women with chronic venous disease during pregnancy is associated with decreased EGFL7 expression level

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

A need for evidence to guide treatment recommendation for women with chronic venous disease during childbearing years

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