Abstract
Objective: Number of pregnancy has a positive correlation with the development of lower limb venous insufficiency. We purpose to reveal the relation between the venous insufficiency in pregnancy and concomittant gestational features.
Method: A retrospective analysis was performed using data collected from the database of our institution between January 2016-January 2021. 35 patients were included. The informations about age, in vitro fertilisation usage, polycystic ovary syndrome (PCOS), free T4 (fT4) and TSH levels, gestational diabetes mellitus (DM), other features and reports of Doppler ultrasound (USG) were investigated. Quantitative variables were analysed using Kolmogorov-Smirnov test. The relation between qualitative variables were analysed using x2 test. Descriptive statistics of qualitative variables were considered as mean±standard deviation, median (25-75 percentile), minimum-maximum. Descriptive statistics of quantitative variables were considered as frequency (%). P <0.05 was considered as statistically significant.
Results: At the time of complain about leg pain and edema in lower extremities, 60% of patients were primigravid, mean age was 28.91±6.94. Mean value of the week of pregnancy was 28.71±7.92 (12-38). Mean value of TSH and fT4 were 1.74±0.86 mIU (0.23–4.07) and 13.78±3.15 pmol/mL (5.06-7.61) respectively. Twelve patients (34.3%) had venous insufficiency in Doppler USG, 3 (25%) of them were in 2nd trimester, 9(75%) were in 3rd trimester. 41.6% had normal delivery and 58.3% had cesarian section previously. fT4/ TSH ratio was 9.98 in Doppler USG positive group and in 3rd trimester had TSH and fT4 level as 1.55±0.44 and 14.62±2.14 respectively.
Conclusion: There wasn’t a close relation between symptoms and venous insufficiency in Doppler USG neither between venous insufficiency and number of pregnancy or previous method of delivery. Even though venous insufficiency increases in the 3rd trimester, venous insufficiency didn’t correlate with TSH and fT4 levels. The ratio of fT4/TSH was sligtly higher in patients with venous insufficiency.
Keywords
References
- Szary C, Wilczko J, Plucinska D et al. The number of pregnancies and deliveries and their association with selected morphological and hemodynamic parameters of the pelvic and abdominal venous system. J Clin Med. 2021;10:736.
- Davies AH. The seriousness of chronic venous disease: a review of real-world evidence. Adv Ther. 2019;36:5-12.
- Dindelli M, Parazzini F, Basellini A, Rabaiotti E, Corsi G, Ferrari A. Risk factors for varicose disease before and during pregnancy. Angiology. 1993;44:361-367.
- Taylor J, Hicks CW, Heller JA. The hemodynamic effects of pregnancy on the lower extremity venous system. J Vasc Surg Venous Lymphat Disord. 2018;6:246-255.
- Struckmann JR, Meiland H, Bagi P, Juul-Jørgensen B. Venous muscle pump function during pregnancy. Assessment by ambulatory strain-gauge plethysmography. Acta Obstet Gynecol Scand. 1990;69:209-215.
- 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;7:84-89.
- Mariola R-L, Jarosław K, Grzegorz B. Risk factors for the development of venous insufficiency of the lower limbs during pregnancy – part 1. Ginekol Pol. 2012;83:939-942.
- Gardenghi LA, Dezotti NR, Dalio MB, Joviliano EE, Piccinato CE. Gestational lower limb edema and venous reflux in healthy primigravidae. Int Angiol. 2017;36:569-573.
- Alavi A, Adabi K, Nekuie S et al. Thyroid dysfunction and autoantibodies association with hypertensive disorders during pregnancy. J Pregnancy. 2012;2012:742695.
- Gupta R, Dhyani M, Kendzerska T et al. Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment. Acta Neurol Scand. 2016;133:320-329.
- Ismail L, Normahani P, Standfield NJ, Jaffer U. A systematic review and meta-analysis of the risk for development of varicose veins in women with a history of pregnancy. J Vasc Surg Venous Lymphat Disord. 2016;4:518-524.
- Lee AJ, Evans CJ, Allan PL, Ruckley CV, Fowkes FG. Lifestyle factors and the risk of varicose veins: Edinburgh Vein Study. J Clin Epidemiol. 2003;56:171-179.
- Pereira JC Jr, Pradella-Hallinan M, Lins Pessoa Hd. Imbalance between thyroid hormones and the dopaminergic system might be central to the pathophysiology of restless legs syndrome: a hypothesis. Clinics (Sao Paulo). 2010;65:548-554.
Abstract
Amaç: Gebelik sayısı, alt ekstremite venöz yetmezlikle pozitif korelasyon gösterir. Çalışmamızda gebelikteki venöz yetmezliğin, gebeliğe eşlik eden özellikler ile korelasyonunu incelemeyi amaçladık.
Yöntem: Ocak 2016- Ocak 2021 arasında hastanemize başvuran 35 hasta retrospektif olarak incelendi. Yaş, in vitro fertilizasyon, PCOS, sT4 ve TSH düzeyleri, gestasyonel DM ve diğer özellikler ile Doppler USG raporları incelendi. Nicel değişkenler Kolmogorov-Smirnov testiyle incelendi. Nitel değişkenler x2 test ile incelendi. Tanımlayıcı istatistikler, ortalama±standard sapma, median (25-75 yüzdelik), minimum-maksimum olarak değerlendirildi. Nicel değişkenlerin tanımlayıcı istatistiği ise frekans (%) olarak değerlendirildi. P<0.05 istatistiksel anlamlı kabul edildi.
Bulgular: Bacak ağrısı ve ödemi gelişmesi anında, %60 hasta primigraviddi. Ortalama yaş 28.91±6.94 idi. Ortalama gebelik haftası 28.71±7.92 (12-38) idi. Ortalama TSH ve sT4 değeri, 1.74±0.86 mIU (0.23–4.07) ve 13.78±3.15 pmol/mL (5.06-7.61) idi. On iki hastada (%34) Doppler USG’de venöz yetmezlik mevcuttu. Bu hastaların 3’ü (%25) 2. trimester, 9’u (%75) 3. trimesterdeydi. % 41.6’sı normal doğum ve %58.3’ü Cesarian ile daha önce doğum yapmıştı. ST4/TSH oranı, Doppler pozitif grupta 9.98 idi. 3. trimesterde TSH ve sT4 düzeyleri sırasıyla 1.55±0.44 ve 14.62±2.14 idi.
Sonuç: Semptom varlığı ve Doppler USG’de venöz yetmezlik oluşu arasında yakın bir ilişki tespit edilemedi. Aynı şekilde venöz yetmezlik ile gebelik sayısı ve önceki doğum metodu arasında yakın ilişki bulunamadı. Venöz yetmezlik 3. trimesterde artsa da, venöz yetmezlik TSH ve sT4 düzeyleri ile korelasyon göstermiyordu. ST4/TSH oranı venöz yetmezlik gösteren gebelerde ılımlı artmıştı.
Keywords
References
- Szary C, Wilczko J, Plucinska D et al. The number of pregnancies and deliveries and their association with selected morphological and hemodynamic parameters of the pelvic and abdominal venous system. J Clin Med. 2021;10:736.
- Davies AH. The seriousness of chronic venous disease: a review of real-world evidence. Adv Ther. 2019;36:5-12.
- Dindelli M, Parazzini F, Basellini A, Rabaiotti E, Corsi G, Ferrari A. Risk factors for varicose disease before and during pregnancy. Angiology. 1993;44:361-367.
- Taylor J, Hicks CW, Heller JA. The hemodynamic effects of pregnancy on the lower extremity venous system. J Vasc Surg Venous Lymphat Disord. 2018;6:246-255.
- Struckmann JR, Meiland H, Bagi P, Juul-Jørgensen B. Venous muscle pump function during pregnancy. Assessment by ambulatory strain-gauge plethysmography. Acta Obstet Gynecol Scand. 1990;69:209-215.
- 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;7:84-89.
- Mariola R-L, Jarosław K, Grzegorz B. Risk factors for the development of venous insufficiency of the lower limbs during pregnancy – part 1. Ginekol Pol. 2012;83:939-942.
- Gardenghi LA, Dezotti NR, Dalio MB, Joviliano EE, Piccinato CE. Gestational lower limb edema and venous reflux in healthy primigravidae. Int Angiol. 2017;36:569-573.
- Alavi A, Adabi K, Nekuie S et al. Thyroid dysfunction and autoantibodies association with hypertensive disorders during pregnancy. J Pregnancy. 2012;2012:742695.
- Gupta R, Dhyani M, Kendzerska T et al. Restless legs syndrome and pregnancy: prevalence, possible pathophysiological mechanisms and treatment. Acta Neurol Scand. 2016;133:320-329.
- Ismail L, Normahani P, Standfield NJ, Jaffer U. A systematic review and meta-analysis of the risk for development of varicose veins in women with a history of pregnancy. J Vasc Surg Venous Lymphat Disord. 2016;4:518-524.
- Lee AJ, Evans CJ, Allan PL, Ruckley CV, Fowkes FG. Lifestyle factors and the risk of varicose veins: Edinburgh Vein Study. J Clin Epidemiol. 2003;56:171-179.
- Pereira JC Jr, Pradella-Hallinan M, Lins Pessoa Hd. Imbalance between thyroid hormones and the dopaminergic system might be central to the pathophysiology of restless legs syndrome: a hypothesis. Clinics (Sao Paulo). 2010;65:548-554.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | August 31, 2022 |
| Submission Date | December 27, 2021 |
| Published in Issue | Year 2022 Volume: 3 Issue: 2 |
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