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

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Quantify the volume and diameter of veins in the lower limbs of primigravidae and associate the presence of venous signs and symptoms with the vascular measurements.

Methods

A cross-sectional study assessed 64 lower limbs of 32 healthy women of whom 16 were primigravidae between 22 and 36 weeks pregnant, and 16 nulligravidae. The women were submitted to physical assessment, air plethysmography and vascular ultrasound. The volumes and diameters of the main veins in the lower limbs were compared between pregnant and non-pregnant women. In the group of pregnant women, the attempt was also made to associate such measurements to the presence of vascular signs and symptoms.

Results

The average venous volume of the lower limbs (110.1 ± 30.2 and 94.7 ± 27.3 mL; p = 0.036), as well as the diameters of the common femoral (12.72 ± 2.27 and 10.14 ± 1.24 mm; p < 0.0001), saphenous (4.81 ± 1.15 and 3.55 ± 0.98 mm; p < 0.0001) and popliteal (6.87 ± 1.68 and 5.36 ± 1.07 mm; p < 0.0001) veins were, respectively, greater in the pregnant women compared with the control group. In pregnant women with venous stasis symptoms, a venous diameter of the saphenous vein compared to those without no symptoms (5.05 ± 1.19 and 4.09 ± 0.70 mm; p = 0.011) was noted.

Conclusions

Anatomical and functional changes in the venous system during pregnancy were detected by the air plethysmography and the vascular ultrasound in primigravidae. In pregnant women, the presence of venous stasis symptoms found an anatomical and functional substrate detected in the differences in diameter of the saphenous vein.

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References

  1. Silva RS (2001) Condutas em ginecologia—aspectos preventivos. Medsi, Belo Horizonte

    Google Scholar 

  2. Macklon NS, Greer IA, Bowman AW (1997) An ultrasound study of gestational and postural changes in the deep venous system of the leg in pregnancy. Br J Obstet Gynaecol 104:191–197

    Article  PubMed  CAS  Google Scholar 

  3. Skudder PA Jr, Farrington DT, Weld E, Putman C (1990) Venous dysfunction of late pregnancy persists after delivery. J Cardiovascular Surg 31:748–752

    Google Scholar 

  4. Rabhi Y et al (2000) Lower limb vein enlargement and spontaneous blood flow echogenicity are normal sonographic findings during pregnancy. J Clin Ultrasound 28(8):407–413

    Article  PubMed  CAS  Google Scholar 

  5. Carvalho EV, Carvalho MSB (2001) Varicose veins and pregnancy. Rev Angiol Cir Vasc 10(1):32–35

    Google Scholar 

  6. Struckmann JR et al (1990) Venous muscle pump function during pregnancy. Acta Obstet Gynecol Scand 69:209–215

    Article  PubMed  CAS  Google Scholar 

  7. Cordts PR, Gawley TS (1996) Anatomic and physiologic changes in lower extremity venous hemodynamics associated with pregnancy. J Vasc Surg 24:763–767

    Article  PubMed  CAS  Google Scholar 

  8. Meissner MH (2005) Lower extremity venous anatomy. Semin Intervent Radiol 22(3):147–156

    Article  PubMed  Google Scholar 

  9. Comerota AG et al (1995) Air plethysmography: a clinical review. Int Angiol 14(1):45–52

    PubMed  CAS  Google Scholar 

  10. Sparey C et al (1999) Serial colour flow duplex scanning of the lower limb throughout pregnancy. Br J Obstet Gynaecol 106:557–562

    Article  PubMed  CAS  Google Scholar 

  11. Spivack DE et al (2012) Mapping of superficial extremity veins: normal diameters and trends in a vascular patient-population. Ultrasond Med Biol 38(2):190–194

    Article  Google Scholar 

  12. Engelhorn CA et al (2004) Can air plethysmography evaluate the severity of chronic venous insufficiency? J Vasc Br 3(4):311–316

    Google Scholar 

  13. Barwin BN, Roddie IC (1976) Venous distensibility during pregnancy determined by graded venous congestion. Am J Obstet Gynecol 125(7):921–923

    PubMed  CAS  Google Scholar 

  14. Celestino RTS et al (2005) Air plethysmography for venous evaluation of the lower limbs during first pregnancy. J Vasc Br 4(2):167–170

    Google Scholar 

  15. Peixoto LHW et al (1991) Estase venosa e gravidez—estudo prospectivo fotopletismográfico. An Paul Med Cir 118:29–38

    Google Scholar 

  16. Anthony B, Rebecca S (2009) Interventions for varicose veins and leg oedema in pregnancy. In the Cochrane Library, Issue 01, Art. No. CD001066. DOI: 10.1002/14651858.CD001066.pub2

  17. Duque FLV (2002) Insuficiência venosa crônica. Pontos de estudo. Publicação interna: Disciplina de Angiologia. Escola Médica de Pós-Graduação da PUC/RIO

  18. Thaler E, Huch R, Huch A, Zimmermann R (2001) Compression stockings prophylaxis of emergent varicoses veins in pregnancy: a prospective randomized controlled study. Swiss Med Wkly 131(45–46):659–662

    PubMed  CAS  Google Scholar 

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Correspondence to Zilma Silveira Reis.

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Goulart, V.B., Cabral, A.C.V., Reis, Z.S. et al. Anatomical and physiological changes in the venous system of lower limbs in pregnant women and findings associated with the symptomatology. Arch Gynecol Obstet 288, 73–78 (2013). https://doi.org/10.1007/s00404-013-2728-9

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  • DOI: https://doi.org/10.1007/s00404-013-2728-9

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